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Biomedical subjects

A Oliaro

Publications and source records attributed to A Oliaro.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

[Neuroendocrine tumors of the lung].

BACKGROUND: To review the patients treated at our Institute over the past 22 years and to evaluate the behaviour of 14 atypical carcinoids on the basis of Capella's classification (1994), defining the most suitable surgical approach. METHODS: A total of 118 patients undergoing surgery for lung neuroendocrine tumours were reanalyzed on the basis of their anatomic and pathological characteristics, surgical treatment and survival. RESULTS: The 5-year survival rate was 96.5% for typical forms and 74.5% for atypical forms; the 10-year survival rate was 92.4% for typical forms and 49.8% for atypical forms (p < 0.001). Lymph node metastatic involvement was also an important contributing factor for survival (p < 0.05). A review of the series of 19 patients treated over the past 6 years, diagnosed with so-called atypical carcinoid based on Capella's anatomic and pathological classification, showed that 5 were well differentiated neuroendocrine tumours (WDNT), 8 well differentiated neuroendocrine carcinomas (WDNC) and 1 small-cell lung neuroendocrine carcinoma (SLCL). From a surgical point of view, 10 cases underwent demolitive surgery and 9 conservative surgery. The overall actuarial survival rate in this series was 78% at 5 years, 100% for WDNT and 75% for WDNC. The only case of SCLC died after a few months. CONCLUSIONS: The authors conclude that the 5 and 10-year probability of survival are closely linked to the histological type of the lung neuroendocrine tumour and the presence of lymph node metastasis. Capella's new anatomic and pathological classification helps to establish a more precise prognosis for so-called atypical carcinoids. Lastly, given the malignant potential of these tumours, preference should be given to radical exeresis.

Adolescent↗
PubMedDate not supplied

The value of selective mediastinoscopy in predicting resectability of patients with bronchogenic carcinoma.

From 1980 to 1990, 1505 patients underwent thoracotomy as definitive treatment for non small cell lung cancer. Computed tomography (CT) of the chest has been used routinely since 1984 for assessment of mediastinal lymph node involvement. A total of 235 cervical mediastinoscopies and 71 anterior parasternal mediastinotomies were performed on the same patient population as preoperative staging when CT scan demonstrated mediastinal lymph nodes larger than 1 cm. Radical resections showed a constant increase in number from 70.1% in the period 1980-84 to 82.7% in the period 1985-90. Exploratory thoracotomies and thoracotomies with residual tumor showed a parallel reduction: 14.5% in 1980-84 to 7.4% in 1985-90 for the former, 15.4% in 1980-84 to 9.8% in 1985-90 for the latter. The percentage of N2 disease to the total number of thoracotomies decreased from 23.6% in 1980-81 to 11.2% in 1989-90. We conclude that a selective use of cervical mediastinoscopy and anterior parasternal mediastinotomy, based upon the results of CT scan, may have contributed to reduce the number of exploratory thoracotomies and thoracotomies with residual tumor.

Carcinoma, Bronchogenic↗
PubMedDate not supplied

Pleural abrasion in the treatment of recurrent or persistent spontaneous pneumothorax. Results of 94 consecutive cases.

In the ten-year period 1982 to 1991, 94 patients underwent pleural abrasion as definite treatment for spontaneous pneumothorax. Surgical indications included: 1) third recurrence of homolateral pneumothorax, 2) second recurrence of homolateral pneumothorax in the presence of alternating pneumothorax, and 3) persistent air leak with incomplete lung re-expansion in the presence of spontaneous pneumothorax treated with pleural drainage for more than 10 days. No deaths were observed in the present series. Post-operative complications were minimal and all reversible, including two cases of pleural effusion, one case of hemothorax, and one case of Horner's syndrome. Eighty cases were followed up from 7 to 91 months. No recurrences occurred during the follow-up period. Clinical, radiological and functional results appear satisfactory. Pleural abrasion seems to represent a valid surgical option in the treatment of recurrent or persistent spontaneous pneumothorax.

Adolescent↗
PubMedDate not supplied

Cancer of the esophagus: ten years' experience.

The paper reports the authors' ten-year experience of the surgical treatment of cancer of the esophagus. A total of 625 patients with esophageal carcinoma were observed during the period 1980-89 of whom 490 were admitted to hospital and, of the latter, 172 (35.1%) were operated with a sectile rate of 86% (148 patients). Data from this period were analysed both retrospectively and prospectively using a computerised system. There were 105 radical operations (70.9%) and 43 palliative operations (29.1%). The 3-year actuarial survival rate was 21.7% and the difference between radical and palliative resections was at the limit of significance (p less than 0.1).

Adult↗
PubMedDate not supplied

Pulmonary function in the patients submitted to lung exeresis.

The effects of lung surgery on respiratory function were investigated in 80 patients; 17 patients were submitted to left pneumonectomy (LPN); 11 patients were submitted to right pneumonectomy (RPN); 7 patients underwent a left upper lobectomy (LUL); 16 patients a left lower lobectomy (LLL); 17 patients were submitted to right upper lobectomy (RUL); 12 patients underwent right lower lobectomy (RLL). All patients were submitted to spirometry and arterial blood gas analysis. The effects of lung surgery on respiratory function depends upon the extent of the resected tissue.

Adult↗
PubMedDate not supplied

[Tolerability to terizidone (TZ) in the treatment of pulmonary tuberculosis in dialyzed patients].

Six dialysed patients affected by tuberculosis involving the respiratory apparatus were included in the study. Antimycobacterial treatment consisted of polychemiotherapeutic combinations using terizidone (TZ). The need to resort to this drug may be explained by the need to exclude normally used drugs (R/AMP, INH, SM) due to resistance, allergy or organ meiopragia. Five patients received terizidone at a dose of 600-900 mg/day for the entire course of treatment, whereas it was necessary to abandon treatment in one patient due to the onset of depressive symptoms which then rapidly regressed following the suspension of TZ therapy. The good level of tolerance demonstrated in the 5 remaining cases confirm the inclusion of this drug in the treatment of a limited number of cases of tuberculosis in dialysed patients.

Adult↗
PubMedDate not supplied

Pulmonary function in patients with pleural effusion of varying magnitude and fibrothorax.

Pulmonary function was studied in sixty patients with pleural effusion and seventy patients with fibrothorax. The patients with pleural effusion were divided into three groups according to the extent of the effusion. The patients were submitted to spirometry and arterial blood gas analysis. The effects of pleural effusion on pulmonary function is evaluated with regards to the size of effusion. Small-size pleural effusion little affects arterial oxygen tension. Pleural effusion and fibrothorax have a similar pattern of pulmonary function.

Adult↗
PubMedDate not supplied

Tracheal stenosis. A study of 100 cases.

A series of 100 cases of tracheal stenoses, 66 non-neoplastic and 34 neoplastic, are reviewed; tracheal resection was performed in 28 inflammatory stenoses and in five tumours. A T-tube stent was used in 12 patients. Results were good in 81% of resections for non-neoplastic stenoses; two out of three resections for adenoid cystic carcinoma are alive after ten years and the third died after two years with metastases; two patients who received a tracheal resection for epidermoid carcinomas died after three and four years with metastases. Inflammatory tracheal stenoses treated using T-tube achieved good results only in one third of cases. Pre-operative preparation is the most important factor to obtain good results: end-to-end anastomosis requires a healthy mucosa without infection or ulcers.

Adolescent↗
PubMedDate not supplied

Clinical importance of tumour markers in the diagnosis of squamous-cell carcinoma of the esophagus.

In order to evaluate the diagnostic value of three tumour markers, CEA, CA 19-9 and TA4-scc, 50 patients affected by squamous-cell carcinoma of the esophagus were studied together with 70 normal controls and 22 patients affected by benign esophageal pathologies. The three tumour markers were assessed in all patients and data were evaluated statistically in order to reveal their sensitivities, specificities and diagnostic values. It was concluded that further studies should be carried out on the marker TA4-scc given its high specificity and sensitivity towards esophageal neoplasias at a relatively early stage.

Adult↗
PubMedDate not supplied

[The current epidemiologic profile of the drug resistance of Koch's bacillus to antitubercular antibiotic chemicals].

The study was conducted on patients with initially diagnosed tuberculosis encountered in 1986-87. A series of 269 bacterial antibiograms performed on sputum [correction of excreate] and other materials was examined in order to ascertain the resistance of Koch's bacillus to R/AMP, INH, SM and EMB. Primary drug resistance was found in 64 cases (23.79% of the total) and was isolated in 32 (11.89%), multiple in the rest. The response to the individual antibiotics was a follows resistance to INH was isolated in 11 cases (4.08%), combined with resistance to other drugs in 27 (10.03%); resistance to SM was isolated in 13 cases (4.81%) multiple in 24 (8.92%); resistance to R/AMP was isolated in 4 cases (1.48%), multiple in 14 (5.2%); resistance to EMB was isolated in 4 (1.48%) multiple in 19 (7.06%). Comparison with earlier studies in the Turin area highlights that the incidence of TB, in decline up to 1979, significantly increased in the period considered.

Antibiotics, Antitubercular↗
PubMedDate not supplied

Gastric angiography: data for oesophagogastroplasty.

A report is presented on an angiographic study of the gastric arterial system conducted on 20 human stomachs taken from cadavers during routine autopsies. The aim of the study was to define the anatomical bases for the supply of blood to the isoperistaltic gastric tubule in oesophagogastroplasty operations. The study reveals that on its own the right gastroepiploic artery cannot ensure adequate vascularisation of the gastric fundus. The importance of pressuring the right hand section of the vascular arch along the small curve was also noted and is due to the constant presence of major anastomoses at antral level with the right gastroepiploic artery. The study also revealed the constant presence of a direct intramural anastomotic circulation between the right and left gastroepiploic arteries.

Adult↗
PubMedDate not supplied

Respiratory function during oxygen administration in chronic obstructive pulmonary disease.

Patient with severe chronic obstructive pulmonary disease (COPD) can develop respiratory muscle weakness and fatigue. Arterial hypoxemia can predispose to this condition. To assess whether O2 administration improved respiratory muscle function and respiratory pattern in COPD 11 patients with chronic hypoxemia were examined. Each patient was first submitted to respiratory function studies, including lung volumes, in normal and recumbent position, respiratory frequency, Ti/Te, Ti/Tot, maximal inspiratory and expiratory pressures (Pimax, Pemax) and arterial gas analysis breathing room air. All these tests were repeated during oxygen Administration through a nasal cannula. The arterial PO2 improved from 50 +/- 7 mmHg to 81 +/- 28 mmHg but the breathing pattern, Pimax and Pemax as well as lung volumes remained unchanged. It is concluded that oxygen, in short term administration, doesn't influence respiratory pattern and muscle function.

Aged↗
PubMedDate not supplied

Resection and radical lymphadenectomy for lung cancer: prognostic significance of lymphatic metastases.

From 1979 to 1987, 1103 thoracotomies were performed in patients with lung cancer: 824 (74.7%) radical resections, 141 (12.7%) palliative resections and 138 (12.5%) exploratory thoracotomies. Among the 965 patients who underwent resection, 539 patients were N0, 190 patients N1 and 236 patients N2. Among patients with N1 disease we observed more frequent hilar metastases in the more advanced tumors (p less than 0.05). In 84 out of the 232 N2 patients (36.2%; 13.4% of all patients) a skipping of all pulmonary sites was observed. The most commonly invaded mediastinal levels were the paratracheal nodes on the right and the aortic nodes on the left, followed by the subcarinal nodes. The greater the neoplastic involvement of pulmonary nodal sites, the higher the percentage of patients with N2 disease and the number of mediastinal levels with tumor cells (p less than 0.05). The 5-year survival rate is 60% for N0, 46% for N1 and 23% for N2 disease. There is no significant difference in survival between N2 and N1 + N2 patients. Metastatic involvement of both upper and lower mediastinal levels carries a poorer prognosis compared to involvement of one compartment only (p less than 0.02). Patients with findings of mediastinal metastatic involvement should be selected: studies on lymphatic metastases are useful to better establish surgical indications for N2 patients.

Humans↗
PubMedDate not supplied

Tuberculosis of the larynx. Today.

Forty-one cases of laryngeal tuberculosis accounting for 0.79% of the TB cases observed in 1975-85 are examined. The M/F ratio was 9.2:1; the mean age 52 years 9 months. In all cases current or earlier tubercular lesions on the pulmonary parenchyma were also noted. The laryngeal sites affected were as follows, in order of frequency: true vocal cords, epiglottis, false cords and laryngeal ventricles, arytenoid and interarytenoid area, subglottic area. The patients were treated with R/AMP, INH, EMB or SM, EMB with satisfactory results. Two cases required exeresis of laryngeal lesions and 3 tracheotomy.

Adult↗
PubMedDate not supplied

The release of thromboxane B2 and 6-keto-PGF1 alpha following pulmonary embolism.

It has been shown in animals that acute obstruction of pulmonary artery branches is followed by an early but shortly lived increase in blood levels of thromboxane B2 and a subsequent longer-lasting increase in blood levels of 6-keto-PGF1 alpha. Our study was conducted on twelve patients with acute pulmonary embolism. Nine were treated with urokinase; three could not be given thrombolytic or anticoagulant drugs due to bleeding peptic ulcer (2 cases) or recent cerebral hemorrhage (1 case). HPLC and RIA tests were performed on arterial blood samples at diagnosis and after 1, 6, 12 and 24 hours. Findings were compared with those in a control group of 6 healthy subjects. There was a difference in prostanoid behaviour between the untreated and urokinase treated patients. Among the former mean TxB2 was significantly raised at clinical onset and began to decline after 6-12 hours, approaching the mean level found among the controls after 24 hours. In contrast 6-keto-PGF1 alpha was raised after 1 hour and gradually declined thereafter. In the subjects treated with urokinase TxB2 was already close to the mean control level after 1 hour; 6-keto-PGF1 alpha had increased after 1 hour but had returned near the control level after 12. The behaviour of prostanoids appears to match the clinical course.

6-Ketoprostaglandin F1 alpha↗
PubMedDate not supplied

Effect of lung resection on pulmonary function. A comparative study in different surgical procedures.

The effect of lung surgery on respiratory function has been investigated in 40 patients considering separately the three main procedures (pneumonectomy, lobectomy and thoracotomy alone) to ascertain if the resected lung and the volume removal can influence this function in the immediate postoperative period. The patients were submitted to spirometry and arterial gas analysis preoperatively and during 9 days postoperation; the tests controlled were VC, FEV1, TV and RR. No significant difference has been noticed among various surgical procedures.

Adult↗