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Biomedical subjects

A Guglielmi

Publications and source records attributed to A Guglielmi.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Prognostic significance of 67-kDa laminin receptor expression in advanced gastric cancer.

The ability of cancer cells to attach to laminin has been correlated with their metastatic potential and highly metastatic cancer cells seem to express on their surface significantly more laminin receptors than do their much less metastatic or benign counterparts. The expression of 67-kDa laminin receptors (LR) was investigated in a group of 75 patients who underwent gastrectomy for advanced gastric cancer, with special reference to the possible role in the tumor progression and in the overall survival. The tumor LR expression was immunohistochemically determined in paraffin-embedded sections using the MLuC5 monoclonal antibody which recognizes the 67-kDa LR and the avidin-biotin immunoperoxidase method. Of the 75 cases analyzed, 43 cases (57.3%) displayed a positive reaction. The cumulative 5-year survival rate was 72.6% (95% CI 52.5-85.3) for patients without expression of LR and 46.6% (29.8-61.8) for those with positive LR expression. A significant association between LR expression and depth of tumor invasion (0.022) was found. By univariate analysis the presence of laminin receptors seemed to be associated with a higher risk of death [RR 1.72 (95% CI 0.71-4.20], but this effect disappeared after controlling for depth of tumor invasion. In conclusion, these results suggest that tumor expression of laminin receptors could be correlated with tumor aggressiveness. However, the prognostic significance of laminin receptor expression is already provided by the depth of tumor invasion.

Aged↗
PubMedDate not supplied

[Recurrence of stomach cancer following surgery].

The purpose of this article is to review the incidence and characteristic of first recurrence in a group of 182 patients who underwent curative surgery with extended lymphadenectomy (> or = D2). The median follow up was 46.4 months (range 14-111). The incidence of relapses was 3.3% in the early gastric cancer and 50.8% in the advanced cancer. First recurrence site was systemic in 69.4% of cases and locoregional in 22.6%. The major site of systemic recurrences were peritoneal surface (64.8%), liver (29.5%), and other extra abdominal metastases (5.7%). In 8% of the cases it was not possible to find the site of recurrence. Surgical resection was possible in only 2 out of 14 cases of local recurrence. The incidence of recurrence were directly correlated with the depth of tumor invasion (T1: 3.3%; T2: 20.6%; T3: 61.5%; T4: 70%) and node metastases (NO: 8.3%; N1+: 44.4%; N2+: 64.3%). In advanced cases the incidence of relapses after D1 lymphadenectomy was significantly higher than after D2 lymphadenectomy: 28.6% vs 5.5% in NO cases and 65.6% vs 49.3% in N+ cases. In conclusion it seems that extended lymphadenectomy is associated with a lower incidence of recurrences after curative surgery.

Female↗
PubMedDate not supplied

Aneurysm of the celiac trunk: diagnosis with US-color-Doppler. Presentation of a new case and review of the literature.

Aneurysms of the celiac trunk are the rarest forms of aneurysms of the visceral arteries. Since 1958, when Schumaker reported the first case to be successfully treated surgically, only 69 cases have been reported in the international literature. The detection of such aneurysms, which are often asymptomatic, is mostly occasional. Approximately 15-20% of cases may be complicated by rupture with a mortality rate of around 80%. This eventuality makes surgical treatment mandatory even in asymptomatic cases. The authors report on their experience with the surgical treatment of one case of aneurysm of the celiac trunk and then go on to review the relevant literature.

Anastomosis, Surgical↗
PubMedDate not supplied

Effect of prolonged dexamethasone on oxygen-dependency in infants with chronic lung disease.

To determine the effect of prolonged dexamethasone therapy on oxygen-dependency clinical phase of prematures with bronchopulmonary dysplasia, we examined a consecutive group of 27 infants (birth weight, < 1500 g and gestational age, < 32 weeks), who remained with a static or deteriorating oxygen-dependency after weaning from the respirator [pre-treatment FiO2, mean +/- SEM over three days (31 +/- 2)%, range (27-73)%]. Twenty five out of 27 infants were weaned from supplemental oxygen during the 42-day steroid treatment period, with a mean (+/- SEM) duration of oxygen supplementation of 16 +/- 4 days. The distribution of the ratios of successive post-treatment FiO2 values with respect to pre-treatment FiO2 shows, on average, a progressive reduction with time. The percentage of the FiO2 decrease is statistically significant at a level of 2 and 3 SD after 3 days and 7 days, respectively and the average FiO2 fall, as function of time, follows an exponential law. It follows that the time spent in oxygen for a single patient may be determined, accounting for the individual severity of pre-treatment FiO2.

Anti-Inflammatory Agents↗
PubMedDate not supplied

[Echo-guided compression in the treatment of femoral pseudoaneurysms secondary to cardiological interventional procedures].

PURPOSE: To analyze perspectively a set of 13 patients affected by femoral artery pseudoaneurysm treated with Us-guided compression. MATERIAL AND METHODS: From January to December 1997 we observed 13 patients (7 females and 6 males; mean age: 67.4 years old) affected by femoral artery pseudoaneurysm which were treated with Us-guided compression. The compression was repeated for 15 minutes up to complete closure of the pseudoaneurysm. Every patient was followed up 24 hours after the procedure, before the discharge and every 3 months. RESULTS: In 6 cases the cardiologic procedure had diagnostic purposes while in 7 cases had interventional purposes. The pseudoaneurysm was located in the common femoral artery in 10 cases, in the superficial femoral artery in 2 cases and in the profunda femoris in the last case. The fistula between the aneurysmatic chamber and the arterial lumen had a mean length of 1 centimeter (range: 0.5-2.5 cm) and the mean diameter of the pseudoaneurysm was 3 centimeters (range: 1.5-6 cm). The mean length of the compression was 34 minutes (range: 10-120 min). The technical success rate was 92.3% with one case of failure in the unique localization in the profunda femoris. The procedure was well tolerated from the patients, with minimal discomfort. After the treatment the mean hospital stay was 2 days and to date we have had no recurrences after a mean follow-up of 18 months. CONCLUSIONS: In accordance with the data of the literature, Us-guided compression is the treatment of choice of femoral pseudoaneurysms after cardiac catheterization. The procedure is well tolerated in almost all the patients and it deters the need of surgery with reduction of complications, costs and hospital stay.

Aged↗
PubMedDate not supplied

[The surgery of abdominal aortic aneurysms synchronous with neoplastic lesions (apropos of 18 personal observations)].

The management of simultaneously occurring abdominal aortic aneurysm and malignancy is controversial. It is unclear whether to treat the aneurysm first or the malignancy, or both simultaneously. If the malignancy is resected first there is a risk of postoperative rupture of the aneurysm. If simultaneous surgery is performed there is a risk of prosthetic graft infection. This condition leads to many therapeutic problems which, by the light of 18 personal cases occurred in almost ten years and the recent literature, are discussed in this paper.

Aged↗
PubMedDate not supplied

[Acute hemorrhage secondary to gastric ulcer. Results of emergency endoscopic treatment in 775 cases].

The aim of this study was to investigate the effects of endoscopic injection therapy on the clinical outcome of patients with gastric ulcer bleeding. Seven hundred and seventy-five patients with gastric ulcer bleeding were observed over a 10-year period (January 1990 to May 2000) in the First Division of General Surgery of the University of Verona. The prognostic and therapeutic implications of endoscopic treatment of acute severe gastrointestinal bleeding were analyzed on the basis of medical history and clinical and endoscopic findings. The ulcers were classified according to Forrest's classification of bleeding activity. Endoscopic therapy was performed in 500 patients with active bleeding. Haemostasis was initially obtained in all patients except one. Rebleeding occurred in 13%. All these patients were treated endoscopically at the first attempt. Multivariate analysis revealed that recent surgery, ulcer site and Forrest classification independently influenced the recurrence rate. The mortality of the entire cohort studied was 8.1%. Only 31 patients (4%) underwent surgical treatment with a higher mortality compared to unoperated patients (19.3% vs 7.7%). Endoscopic treatment is a safe procedure with a low mortality and cost, and, if successful, substantially reduces the need for emergency surgery.

Acute Disease↗
PubMedDate not supplied

[Acute hemorrhage caused by duodenal ulcer. Results of endoscopic treatment of the first bleeding episode and of recurrences].

BACKGROUND: The aim of this study was to evaluate the impact of immediate endoscopic treatment of bleeding and rebleeding on the clinical outcome of patients with duodenal ulcer hemorrhage. MATERIALS AND METHODS: Between January 1995 and December 1998, 445 patients with bleeding duodenal ulcers were observed in the First Division of General Surgery--University of Verona. All patients, except two who died for hemorrhage before the endoscopic examination, underwent emergency endoscopy within 2 hours from the admission and ulcers with active or sign of recent bleeding were submitted to injection therapy. History, clinical and endoscopic findings, recurrent bleeding and outcome were prospectively collected and analyzed. Recurrent bleeding underwent immediate endoscopic retreatment as first attempt. RESULTS: Endoscopic therapy was performed in 277 patients with active bleeding and hemostasis was initially obtained in all patients except one. Rebleeding occurred in 62 patients (14%) and endoscopic treatment was successful in 85% of first rebleeding and in 58% of the cases with 2 or more rebleeding. Multivariate analysis showed that systolic blood pressure at admission, ulcer size and Forrest classification influenced independently the recurrence rate. The 30 days mortality was 12.2% in the whole series: 35 deaths (9.2%) in the group without recurrence and 19 (30.6%) deaths in the rebleeding group (p = 0.001). Only 22 patients (5%) underwent surgical treatment with a higher mortality compared to not operated patients (36.4% versus 10.9%). CONCLUSIONS: Endoscopic treatment was associated with reductions of the risk of recurrent bleeding and surgery without increasing mortality rate.

Acute Disease↗