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Biomedical subjects

A Ferrero

Publications and source records attributed to A Ferrero.

At least 37 records · Page 2Linked to original sources
PubMed2000

Patterns of recurrence in patients with squamous cell carcinoma of the vulva. A multicenter CTF Study.

BACKGROUND: Invasive vulvar carcinoma is a rare disease with an incidence rate of 3-5% of all female genital neoplasms. The current study discusses the limited number of articles in the literature regarding the patterns of recurrence as well as the clinical outcome of patients with recurrent disease based on a consistent and consecutive series of cases. METHODS: A common clinical chart focusing on the study of patterns of recurrence was used in five Italian gynecologic institutions with uniform criteria of surgical nomenclature, pathologic variables, and sites of recurrence. Between 1980-1994, 502 cases of primary invasive squamous carcinoma of the vulva were registered consecutively, treated, and considered for this multicentered study. RESULTS: Of 502 patients, 187 (37.3%) developed a recurrence. Distribution of the recurrences by site was as follows: perineal, 53.4%; inguinal, 18.7%; pelvic, 5.7%; distant, 7.9%; and multiple, 14.2%. In a multivariate analysis, 3 characteristics appeared to be statistically correlated with the risk of recurrence: International Federation of Gynecology and Obstetrics Stage > II (P = 0.029), positive lymph nodes (P = 0.009), and vascular space invasion (P = 0.004). The 5-year survival rate was 60% for perineal recurrences, 27% for inguinal and pelvic recurrences, 15% for distant recurrences, and 14% for multiple recurrences. CONCLUSIONS: In the current study the prognostic factors found to have statistical significance as prognostic factors for risk of recurrence were tumor dimension, lymph node involvement, and stromal and vascular space invasion. The presence of inguinal lymph node metastases was predictive of multiple and distant recurrences with a low rate of incidence of isolated perineal recurrence (27%) compared with negative lymph node cases (57.5%). Survival analysis of recurrent disease showed that the surgical resection of local recurrences may provide acceptable results (51% at 5 years). This observation may justify a follow-up program aimed at identifying those patients with early local recurrence suitable for radical resection.

Adult↗
PubMed2000

[Characteristics of atrial electrograms recorded in radiofrequency induced block lines in an experimental model].

AIM: To analyze and quantify atrial electrogram modifications following the induction of linear lesions in the atrial wall using radiofrequency ablation procedures. METHODS: An epicardial multiple electrode (221 unipolar electrodes) was used in 12 Langendorff perfused rabbit hearts to analyze atrial activation before and after radiofrequency induction of a linear lesion in the left atrial wall. After confirming the existence of conduction blockade in the lesion zone by epicardial mapping and propagation vector analysis, six electrodes each were selected in the lesioned and non-lesioned zones in all experiments, comparing the amplitude, maximum negative slope and morphology of the electrograms in both zones, before (control) and after radiofrequency delivery. RESULTS: Analysis of the reproducibility of the measurements in two consecutive cycles showed a variation of 1 +/- 5% for amplitude (NS) and 1 +/- 9% for maximum negative slope (NS). In the non-damaged zone, amplitude (105 +/- 22%) and slope (92 +/- 16%) (values normalized with respect to those recorded before radiofrequency) did not vary significantly following radiofrequency, and simple electrograms were the most frequent recordings (82 vs 83% in control; NS). Amplitude (19 +/- 7%, p < 0.001) and slope (24 +/- 11%; p < 0.001) decreased significantly in the lesion zone, as did the percentage of simple electrograms (6 vs 86% in control; p < 0,001). In this same zone the morphology could not be determined in 12% of the recordings, while multiple electrograms were obtained in 15% (vs 2% in control; p < 0.01), and the most frequent type corresponded to double electrograms (67 vs 12% in control, p < 0.001), with both components coinciding in time with atrial activation in the zones proximal and distal to the lesion line. CONCLUSIONS: Electrograms recorded directly in radiofrequency induce block lines show a significant decrease in amplitude and maximum negative slope. Double electrograms predominate in these recordings, both components of which represent activation on either side of the lesion. In a small proportion of cases simple and multiple electrograms can also be recorded in the block line.

Animals↗
PubMed2000

Spontaneous rupture of hepatocelluar carcinoma: surgical resection and long-term survival.

AIMS: Spontaneous rupture of hepatocellular carcinoma (HCC) is a life-threatening event, particularly in patients with associated cirrhosis. We present our experience of hepatic resection of ruptured HCC. METHODS: We performed 199 resections of hepatocellular carcinoma between January 1984 and December 1999. Six (3%) of these patients were operated on as an emergency because of haemoperitoneum: in five the liver was cirrhotic. RESULTS: The mean duration of the operation was 195+/-101 min; all the patients received blood transfusions. The overall morbidity was 50%, with a mortality rate of 16.5%. Three patients were alive at 50, 80 and 116 months respectively; two had an intrahepatic recurrence treated by chemoembolization. CONCLUSIONS: Non-surgical treatment of spontaneously ruptured hepatocarcinoma should be performed only in patients with contraindication to surgery. Hepatic resection should be the treatment of choice since, according to our experience, long-term results are similar to those of elective surgery.

Adult↗
PubMed1999

Primary neuroendocrine carcinoma of the liver: difficult diagnosis of a rare neoplasm.

Primary neuroendocrine neoplasms of the liver are extremely rare: about 30 cases only have been described in the literature. We report the case of a 42-year-old woman with a ten-year evolution. According to the previously reported cases, primary neuroendocrine carcinoma of the liver is usually multicentric, often mimicking liver metastases. The demonstration of the hepatic origin of a neuroendocrine carcinoma is often arduous. A careful surgical exploration and a prolonged follow-up are mandatory. The treatment of choice is surgical resection when possible. For progressive and unresectable disease, hepatic arterial chemoembolization may be considered. However, the prognosis of liver neuroendocrine tumours is much more favorable than that of hepatocellular carcinoma and progression has to be demonstrated before instauration of potentially harmful therapies.

Adult↗
PubMed1998

Laparoscopic splenectomy. How to make it easier using an innovative atraumatic suction grasper.

BACKGROUND: With the evolution of laparoscopic surgery comes the need for specific instruments that apply traction to parenchymal tissue, like the spleen, without exposing the organ to the associated high risk of bleeding. To meet this need, we designed and developed a suction-cup grasper that allows easy grasping and manipulation of the spleen. Some of the difficulties usually encountered during laparoscopic splenectomy may be overcome by using this device. MATERIALS: The instrument consists of a cone-shaped, silicone rubber suction cup designed with an antislip internal surface. The cup is connected to a support arm with a flexible distal end that can be rotated. Traction is exerted with a commonly available suction system. The device is inserted through a 12-mm-diameter guide sheath. RESULTS: The two interventions performed with the atraumatic device were completed with laparoscopic technique. No complications arose during or after the operations. The average operating time was 110 min. The patients were discharged after 4 and 5 days postoperative, respectively. CONCLUSIONS: As a device specifically designed for grasping parenchymal organs, the atraumatic suction grasper affords the operator a faster and safer technique in laparoscopic splenectomy.

Equipment Design↗
PubMed1998

Laparoscopic adrenalectomy: advantages of an atraumatic suction grasper.

Laparoscopic adrenalectomy still presents some technical problems. The impossibility of directly grasping the gland is the main difficulty. To overcome this problem, we have begun to use an atraumatic suction grasper. From September 1995 to December 1997, 15 laparoscopic adrenalectomies were performed. Group 1 comprised 8 patients operated on without the atraumatic suction grasper; group 2 consisted of 7 patients who underwent a laparoscopic adrenalectomy with the use of this new device. The surgical technique with the use of an atraumatic suction grasper is described. No significant difference was noted between the two groups except in the operative time, which was reduced in group 2, and in the surgeon's comfort. The reported advantages are a direct grasp of the adrenal gland without the risk of squeezing, rupture, or bleeding; a better exposure of the adrenal vessels; and shorter operating time.

Adrenal Gland Neoplasms↗
PubMed1996

Primary adenocarcinoma of the angle of Treitz. Case report and review of the literature.

We describe a 54-year-old man who was referred with the diagnosis of adenocarcinoma of the angle of Treitz and treated with the use of a duodenojejunal segmentary resection. After a review of the literature, we emphasize the difficulty of making an early diagnosis and discuss the most appropriate surgical treatment of tumors of the angle of Treitz. The better prognosis of these neoplasms compared with those of the proximal duodenum can be supported by some embryological findings observed from a different research project currently in progress.

Adenocarcinoma↗
PubMed1996

Complicated jejunal diverticulosis: report of a case.

The authors report a case of complicated multiple jejunal diverticulosis and review the data from the literature on this pathology. A 74-year-old man was admitted to our unit presenting with symptoms of intestinal obstruction. He had previously experienced three episodes of the same symptomatology with melena. Endoscopy excluded gastroduodenal or colonic bleeding; an X-ray of the small bowel detected multiple large jejunal diverticula. The patient underwent surgery: a jejunal resection was performed just below the Treitz angle extending about 60-70 cm. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. At present, the patient is doing well and has not since demonstrated any symptoms of either intestinal obstruction or melena.

Aged↗
PubMed1996

[Gallbladder carcinoma. Our experience].

The authors report their experience of 18 patients with primary cancer of the gallbladder. On 10 patients at stage IV, 9 had a preoperative diagnosis, while at stage 0-1 and 2 the diagnosis was intraoperative or histologic. Every patient had a cholelithiasis at the same time. The authors discuss prophylactic cholecystectomy, even without specific symptoms, and emphasize the need for a better morphological and radiomorphological classification. In the light of the new microinvasive surgical techniques, they briefly discuss laparoscopic cholecystectomy and histologic diagnosis of carcinoma of the gallbladder.

Adenocarcinoma↗
PubMed1995

Differential regulation of transforming growth factor beta-1 gene expression by glucocorticoids in human T and glial cells.

The inflammatory process in the brain requires bidirectional interaction of the immune and nervous systems. Evidently, astrocytic glial cells play an important role in facilitating this communication by releasing immunomodulators and cytokines. Expression of transforming growth factor beta-1 (TGF beta-1), a potent inhibitor of T cell function and glial cell proliferation, is highly regulated in T cells and is believed to be an important component in the molecular interaction between the immune and nervous systems. Comparative analysis of TGF beta-1 gene expression in human T and glial cells by Northern hybridization and S1 nuclease protection assay showed that dexamethasone (DM) caused a significant decrease in the basal and PMA-induced levels of TGF beta-1 mRNA in glial cells but not in T cells. This reduction correlated with a lower level of TGF beta-1 protein production. Transient transfection assay using deletion constructs of the 5' TGF beta-1 gene promoter-containing sequences between -453 and +11 bp identified a region spanning -160 to -60 bp as a potential sequence responsive to regulation by DM in T cells, whereas in glial cells, the overall transcriptional activity of the 5' TGF beta-1 promoter was reduced after DM treatment, but promoter activity within each construct remained constant in response to DM. Thus, a DM-responsive region could not be identified within the TGF beta-1 promoter in glial cells. These findings suggest that TGF beta-1 gene expression is differentially regulated by distinct regulatory elements in T and glial cells, and that extracellular stimulators, including glucocorticoids, can utilize the TGF beta-1-regulatory pathway to affect the functions of neural and immune cells.

CD2 Antigens↗
PubMed1995

Surgery of the incidentally discovered mass of the adrenal gland (incidentaloma).

The authors present their experience about surgery in adrenal gland incidentaloma, during a period of 12 years (1982-1993), at the VI Division of General Surgery, University of Turin. In 17 patients, of 70 who underwent adrenalectomy, the adrenal neoplasm was located thanks to a diagnostic investigation (ECI or CT) executed for other reasons. In ten cases was diagnosed adenoma, in five cases carcinoma, in two cases cysts. In the diagnostic approach to adrenal incidentaloma we did not search for possible hormonal activity, since the patients had been previously selected from specialized endocrinological centres. At present, biological markers not being certain or absolute radiological significance so as to detect benignant from malignant forms. In accordance with international Literature the size of the neoplasm is the discriminant element for adrenalectomy. We have removed the incidentaloma in all cases, be it clinically or subclinically functional and the silent forms > 4 cm as we have observed a statistically significant difference (p < 0.0002) between the benign and malignant lesions, particularly those measuring more than 4 cm in diameter. We suggest a screening with CT scan every three months in lesions < 4 cm, silent and those > 4 cm in patients over sixty years with a morphological aspect of the bening form.

Adenoma↗