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Biomedical subjects

A Mazziotti

Publications and source records attributed to A Mazziotti.

At least 73 records · Page 4Linked to original sources
PubMed1991

An unusual case of hepatic tumor.

A case is reported of a large hepatic tumor in a patient aged 71. Preoperative diagnostic techniques, including echography, CT and angiography, did not provide sufficient criteria for a precise diagnosis. The mass was removed with an extended right hepatectomy with no particular physiopathological consequences. Histological analysis revealed that this was a metastasis from a melonoma of the choroid, operated on 17 years previously.

Aged↗
PubMed1991

Coagulation and fibrinolysis in orthotopic liver transplantation: role of the recipient's disease and use of antithrombin III concentrates. S. Orsola Working Group on Liver Transplantation.

In this study we report the data obtained from extensive haemostatic testing of 25 patients undergoing orthotopic liver transplantation and the results of an open randomized pilot trial of antithrombin III concentrate administration during surgery. Marked differences in transfusional needs and in pre- and intraoperative blood coagulation and fibrinolytic changes were observed between recipients with liver cirrhosis and those with primary biliary cirrhosis. In the former, the increases in tissue-type plasminogen activator activity, total euglobulin fibrinolytic activity, and fibrin-derived degradation products occurred earlier and were more marked, as were the signs of increased thrombin formation. Supplementation of antithrombin III concentrate during surgery failed to induce significant changes in the main parameters studied and in the transfusional needs.

Adult↗
PubMed1991

[The usefulness of angiographic studies in the vascular complications of liver transplantation. The authors' own experience].

The authors report their experience with angiographic techniques in the diagnosis of vascular complications after liver transplantation. From 1986 to 1990, 78 patients were transplanted in our Hospital; of them, 8 underwent angiographic investigations for vascular complications. Angiography is very important when vascular complications are suspected, in the patients with a rise in cytolytic enzymes and in bilirubine levels, with hyperpyrexia, and with bioptic confirmation of no rejection. Duplex US is useful in the evaluation of portal canalization; if there are any doubts, angiography is performed also in the preoperative phase.

Adult↗
PubMed1991

Reversal of primary liver graft non-function using prostaglandins.

Primary graft non-function remains one of the most life-threatening problems after liver transplantation. Its etiology is still unclear. Liver retransplantation is the only therapeutic alternative to this problem. The PGE1 series of prostaglandins have recently been successfully used in the treatment of transplanted organ dysfunction. In this paper we describe a case of primary graft non-function successfully treated with continuous infusion of prostaglandin PGE1, and we briefly discuss the pathogenetic and therapeutic hypotheses.

Alprostadil↗
PubMed1990

Percutaneous alcohol injection of portal thrombosis in hepatocellular carcinoma: a new possible treatment.

Hepatocellular carcinoma (HCC) with portal thrombosis is usually regarded as a contraindication for surgery and for percutaneous alcohol injection (PAI). For palliative purposes we used PAI in 4 patients with infiltrative HCC and segmental portal thrombosis. Ethanol, injected directly into the thrombus, diffused mostly along it. No complications emerged after 20 injections. In the first patient, who later received a liver transplant, the thrombus was completely necrotic. In the other patients, biopsies yielded only necrotic material: in two cases, progression of the thrombus was stopped at 4 and 12 months of follow-up, and in one case the thrombus shrank and remained as such 13 months later. This preliminary experience might broaden the scope of treatment for HCC.

Carcinoma, Hepatocellular↗
PubMed1990

The capsule surrounding primary liver tumors: wherefrom its prognostic significance?

Primary liver neoplasms in cirrhotic and non-cirrhotic patients were studied by electron microscopy and immunohistochemical methods for extracellular matrix (ECM) antigens. A capsule of variable thickness was present in many expanding hepatocellular carcinomas, while it was absent in those of small size, and either fragmented or absent in the infiltrating ones. In the capsules of early onset, fibronectin was the most frequent stromal glycoprotein. In the completely formed capsular structures, fibronectin, type-V collagen and laminin were the most common macromolecules seen. No differences were evident in the pattern of ECM macromolecules in the capsules surrounding hepatocellular carcinomas compared with those found in benign lesions, such as hepatocellular adenomas or focal nodular hyperplasia. The possibility is discussed that the capsule could be a result of the following sequence: tissue with expansive (not infiltrative) growth-mechanical compression-ischemic necrosis of surrounding tissues-repair process with ECM deposition.

Carcinoma, Hepatocellular↗
PubMed1990

Relationship between alpha-fetoprotein serum levels, tumour volume and growth rate of hepatocellular carcinoma in a western population.

In order to detect a possible relationship between alpha-fetoprotein (AFP) levels, total tumour volume at the moment of the discovery and the tumour volume doubling time, we studied a population of 138 patients, affected by Hepatocellular Carcinoma (HCC) discovered at abdominal ultrasound (US) examination and confirmed by liver biopsy in all cases. In each patient the serum AFP level was determined within a week before or after the US examination. A small therapy-free subgroup of 23 patients, was also serially observed for a mean period of 4 months, so making possible the evaluation of the tumour volume doubling time and its relationship with the initial value of AFP. In 81 patients (58.7%) the serum AFP resulted less than 20 ngr/ml in 21 (15.2%), between 20 and 200 and in 36 (26.1%) greater than 200ngr/ml. No statistical correlation was found between the tumour volume calculated on the basis of the US image at the moment of the discovery and the AFP level, even though very high levels (greater than 3000) were found only in large tumours. Furthermore the tumour doubling time was not correlated with the initial value of AFP.

Adult↗
PubMed1989

Primary liver neoplasms: evaluation of proliferative index using MoAb Ki67.

Thirty-two cases of primary liver neoplasms comprising 12 benign, 15 malignant, and 5 cases with equivocal histopathological features between benign and malignant have been investigated using monoclonal antibody (MoAb) Ki67, which reacts with a nuclear protein expressed in the G1, G2, S, and M phases of the cell cycle. The Ki67 score (positive cells/total neoplastic cells) seems to correlate to the classes of lesions tested. In the hepatocellular carcinoma (HCC) group, the percentage of labelled nuclei, ranging from 15 to 50 per cent, showed a good correlation with Edmondson-Steiner's histological tumour grade. A percentage of positive cells similar to that of the proved low-grade HCCs was detected in the five neoplastic lesions in which the routine histopathological criteria of malignancy were not fulfilled. The benign neoplasms showed a very low growth fraction, similar to that of normal or cirrhotic tissues. The use of the Ki67 score seems to offer useful information about the biological behaviour of some liver masses and may help in the differential diagnosis of hepatocellular adenoma versus carcinoma.

Antibodies, Monoclonal↗
PubMed1988

Clinical experience with hepatic resections for hepatocellular carcinoma in patients with cirrhosis.

The results of 31 resections of the liver performed upon patients with cirrhosis and hepatocarcinoma are reported herein. The lesions were discovered mainly during routine echographic surveillance. Twenty-five of these patients with small tumors underwent a segmentary or subsegmentary resection. Intraoperative ultrasonography proved to be of paramount importance in these instances as it helped to recognize the lesion and outline the limits of the resection. In another 11 instances of primary tumors of the liver in patients with cirrhosis who underwent laparotomy, findings from intraoperative ultrasonography advised against exeretic operation because other intrahepatic lesions or neoplastic thrombi in portal branches were detected. The operative mortality rate in the 31 patients who underwent resection of the liver was 12.9 per cent. The actuarial three year survival rate is 58 per cent. The presence of an intact peritumoral capsule seems to be the best prognostic factor.

Adult↗
PubMed1987

Hepatocellular carcinoma: expression of basement membrane glycoproteins. An immunohistochemical approach.

The identification and characterization of collagenous and non-collagenous glycoproteins have made it possible to use specific antibodies as tools for the topographical localization of the various connective tissue components, and thus to follow the progression of parenchymal-stromal interactions. This investigation is an approach to the study of in vivo relationships between basement membrane components (type IV collagen, laminin) and neoplastic cells of hepatocellular carcinoma. Ten cases of hepatic carcinomas were analysed and paraffin-embedded sections were immunostained with anti-laminin and anti-type IV collagen antibodies. The avidin-biotin-peroxidase complex technique was used. In well differentiated neoplasms with hepatic tumour cells organized in a trabecular pattern lined by sinusoid structures, type IV collagen was always detected at the sinusoidal level. Laminin was evident only in two cases with a prominent intraparenchymal vascular bed. In less differentiated neoplasms, sinusoids were almost absent and only large tumour vessels were positive for both laminin and type IV collagen. At the interface between tumour tissue and the surrounding stroma, some carcinomatous elements were surrounded by laminin and type IV collagen. Our data further support the hypothesis that basement membrane phenotypic expression may be influenced both by the degree of tumour differentiation and by the characteristics of the micro-environment.

Basement Membrane↗
PubMed1987

Primary liver cell carcinoma. New insight for a more correct approach to its classification.

Hepatocellular carcinomas, cholangiocellular carcinomas, and "indeterminate" forms have been studied by immunohistochemical detection of several antigens: alpha-fetoprotein and CEA, as well as type IV collagen, laminin, and keratin. While the first two antigens were variably detectable in different samples, in the poorly differentiated areas of hepatocellular carcinoma type IV collagen and laminin were both absent. These basement membrane glycoproteins constantly surrounded the cholangiocellular carcinoma tubular structures and were always present in those areas of the "indeterminate" group where the cells were organized as pseudoglandular or ductular aggregates. Keratin was absent in all cases of hepatocellular carcinoma, was variably detectable in the "indeterminate" neoplasms and was always present in cholangiocellular tumors. The neoplasias with mixed histopathological features usually showed morphological and biochemical biliary differentiation at the periphery, in contact with the collagenous stroma. We postulate that in some cases hepatocarcinoma cells undergo metaplastic transformation giving rise to cholangiocellular forms. Type IV collagen, laminin, and keratin seem to be accurate markers of phenotypical differentiation and show that a continuous phenotypical spectrum exists between hepatocellular and cholangiocellular entities.

Adenoma, Bile Duct↗
PubMed1987

Campylobacter infection masquerading as ulcerative colitis.

A 24-year-old woman noted erythematous tender nodules on her extremities and temporal areas while being treated for Campylobacter-positive colitis. Histologic examination showed groups of inflammatory cells in the subcutaneous tissue and dermis around pilosebaceous follicles and sweat glands. The diagnosis of nonspecific, chronic dermatitis and panniculitis was made. The cutaneous lesions improved with the administration of tetracycline, Azulfidine, and adrenocorticotropic hormone, after which a negative culture for Campylobacter was obtained. Campylobacter colitis may stimulate ulcerative colitis.

Adrenocorticotropic Hormone↗
PubMed1986

Spontaneous mediastinal hemorrhage secondary to oral anticoagulation.

We report a rare case of spontaneous mediastinal hemorrhage secondary to appropriate oral anticoagulation in an otherwise healthy 35-year-old woman. This case was unique in view of the patient's age and the fact that she had no underlying pathologic condition. Although the literature describes only two other cases of spontaneous mediastinal hemorrhage secondary to oral anticoagulant therapy alone, such bleeding has also been observed in patients on combined oral anticoagulant and fibrinolytic therapy and on heparin therapy. Therefore, this kind of hemorrhage should be included in the differential diagnosis of chest pain in such patients. The diagnosis is confirmed by chest X-ray films, computer tomographic scanning, and digital angiography. Supportive treatment is usually sufficient, since tamponade tends to intervene before cardiac compromise can occur.

Journal Article↗