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Biomedical subjects

A Paolini

Publications and source records attributed to A Paolini.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Leiomyoma of the esophagus].

In this paper the Authors report a review of the clinical records from 1972 to 1985 of the Institut of IV Clinica Chirurgica of Rome of esophageal leiomyoma. We report on 7 cases: three males and four females. Their ages ranged from 37 to 78 years (mean 54 years). The most frequent symptoms were dysphagia (71.4%), loss weight (57.1%) and slight epigastralgia (42.8%). Barium meal, esophagoscopy, esophageal manometry, TAC are the most sensitive procedures for a correct preoperative diagnosis. The therapy of choice is surgical treatment. However surgery is conservative: extramucosal enucleation of the leiomyoma is the procedures of choice. The postoperative course was free of complications, the long-term results were excellent.

Adult↗
PubMed1992

Left ventricular diastolic filling in type I diabetes mellitus: a pulsed Doppler echocardiographic study.

OBJECTIVES: Doppler echocardiography was used to assess left ventricular diastolic performance in young patients with type I diabetes mellitus and no clinical signs of heart disease. METHODS: The pattern of transmitral diastolic flow velocity was determined in 82 patients (56 men, 26 women; age 17.7 +/- 7.6) with type I diabetes mellitus and no heart disease. Maximal early diastolic flow velocity (E peak), maximal late diastolic velocity (A peak), the ratio of maximal flow velocity in late diastole to that in early diastole (A/E ratio) and the ratio of the time velocity integral of the diastole (1/3 FF) were measured in all 82 patients and repeated during exercise in 63 of them. Twenty healthy volunteers served as controls. RESULTS: Mean values of the Doppler indexes were not significantly different between the patients and the 20 controls, but diabetic patients with microvascular complications showed patterns of left ventricular diastolic flow velocity which suggested altered diastolic performance, namely lower E peak velocity, higher A peak velocity, raised A/E ratio and reduced 1/3 FF. Among the 63 examined during exercise, different diastolic flow patterns in response to effort made it possible to identify 15 patients with a high rate of autonomic dysfunction, indicating probable impairment of diastolic function and a need for close follow-up. CONCLUSION: Diastolic abnormalities may occur in young diabetic patients without evidence of heart disease and suggest Doppler evaluation is a sensitive method for identifying patients at potential risk of developing clinical heart disease.

Adolescent↗
PubMed1992

[Prognostic factors in bronchopulmonary neoplasms].

The paper aims to illustrate the current state of knowledge regarding the prognostic factors of lung cancer. The disappointing results obtained using therapeutic modes (an overall 5-year survival rate of 15%), together with the considerable variability of the natural history of lung cancer, should be attributed to a group of prognostic factors, of varying importance, which can be subdivided into three categories: those concerning the characteristics of cancer, those inherent to the patient's conditions and those related to the type of operation. The paper underlines that histotype, TNM staging, the assessment of the nuclear degree and ploidy class play a correct and real prognostic role, and that only surgical treatment, if indicated, can offer a real life expectancy (40% 5-year survival rate in operated patients).

Humans↗
PubMed1992

[Staplers and pulmonary surgery].

The Authors report their experience with staplers (model T.A. 30) in lung surgery: 152 stapled sutures were, in fact, performed in the IV Surgical Department of the University "La Sapienza" of Rome, during the period 1980/90. The use of staplers assures a perfect closure and prevents granulomas due to suture materials in typical as well as atypical lung resections.

Adenocarcinoma↗
PubMed1991

[Current aspects and controversies in reconstructive surgery after esophagectomy: personal experience].

The authors report their series of 184 esophagectomies performed both for benign (44) and malignant (140) diseases. On the basis of their experience and supported by Literature data, it is believed restoration of digestive continuity offers two main points of discussion: choice of the intestinal tract for the interposition and type of anastomosis to perform. The nature of the lesion and its level seems to play the most important role in the choice.

Anastomosis, Roux-en-Y↗
PubMed1990

[100 cases of bronchial mechanical sutures].

The Authors report their experience with stapler model T.A. 30 in lung resections; 100 stapled sutures were carried out in the IV Surgical Department of the University "La Sapienza" of Rome, during the period 1980-88. The use of stapler with two rows of staples allows a secure closure of the bronchial stump. Moreover, it prevents granulomas caused by suture material. The bronchopleural fistulas, serious complications of manual suturing, did not occur. Finally, this method is simpler and rapidly feasible in comparison with classic ones.

Bronchi↗
PubMed1990

Heller-Belsey and Heller-Nissen operations for achalasia of the esophagus.

From 1972 to 1985, 101 consecutive patients underwent Heller's myotomy and Belsey repair (H + B) (n = 43) or Nissen fundoplication (H + N) (n = 58) for achalasia of the esophagus. There was no operative mortality after either operation; minor pulmonary complications occurred after H + B procedure in 9.3 per cent of the patients. Good to excellent long term results were achieved in 87 per cent of the patients after H + B repair and 83 per cent of the patients undergoing H + N. The failure rates were 2.5 and 11.3 per cent, respectively. The analyses of postoperative esophageal symptoms showed that the incidence of heartburn was greater after H + B repair and the incidence of obstructive symptoms was greater after H + N. The inability to vomit or belch, or both, was 10.2 per cent in the H + B group and 13.1 per cent in the H + N group. Finally, 56.4 per cent of patients after H + B repair and 41.0 per cent of those after myotomy and H + N were considered to be cured after the operative procedure was performed. Patients were improved in 41.0 and 47.3 per cent, respectively.

Adolescent↗
PubMed1989

[Reconstruction of the thoracic wall using a Marlex sandwich. Presentation of a clinical case].

The case of a 78-year-old male with a large, firm, not tender mass of the left anterolateral region of the chest is reported. Previously he had been treated with cyproterone acetate for a year, being affected by a locally unresectable prostate carcinoma. At CT-scan of the chest mass appeared solid, extending to the pleural cavity with compression of the lung and erosion of third to fifth rib. Operation consisted in complete removal of the mass with "en bloc" resection of involved ribs. Chest wall was reconstructed by means of a Marlex mesh sandwich. Histology revealed a carcinoma, probably originating from the breast. The role of antiandrogenic chemotherapy in the development of the tumor and the use of plastic mesh for chest wall defects are discussed.

Aged↗
PubMed1989

Belsey and Nissen operations for gastroesophageal reflux.

From 1972 to 1985, 37 consecutive patients underwent primary Belsey repair and 40 consecutive patients underwent primary Nissen fundoplication because of reflux disease. The operative procedures were performed by a single surgeon in each group. For the purpose of comparison, both groups were divided into two subsets: (1) patients with proved reflux, and (2) patients with different indications. The first subset consisted of 30 patients in the Belsey series and 32 in the Nissen series. The remaining patients were included in the second subset. One death occurred in the Belsey series; morbidity consisted of minor pulmonary complications in the Belsey series (10.8%) and spleen injuries requiring splenectomy (5%) in the Nissen series. In patients with proved reflux good-to-excellent results were achieved in 89.3% of subjects of the Belsey series and 86.6% of patients of the Nissen group. The failures rates were 7.1% and 10%, respectively. Inability to vomit and/or belch was reported in 7.1% of patients with proved reflux of the Belsey group and 10% of patients with proved reflux of the Nissen group. In patients with different indications there were no failures after either operation. Finally 82.2% of subjects in the Belsey group and 73.3% of patients in the Nissen group declared that they were satisfied with the operative results. In conclusion the Belsey and the Nissen procedures are equally able to achieve long-term control of reflux disease in comparable groups of patients. Failures and gastrointestinal symptoms are equally frequent after either procedure and do not affect the overall patient acceptance of antireflux surgery.

Adult↗
PubMed1987

Effects of three new anthracyclines and doxorubicin on the rat isolated heart.

The acute cardiac toxicity of three second-generation anthracycline analogues and doxorubicin was compared in a model of the rat isolated Langendorff perfused heart. The drugs, doxorubicin (DX), 4-epi-doxorubicin (4'EDX), 4-demethoxy-daunorubicin (4DMDR) and 4'-deoxy-doxorubicin (4'dxDX) were infused for 40 min at a concentration of 26 microM into the isolated hearts. All four compounds significantly reduced cardiac work and its first derivative. The time to 50% decrease in work (TW50) was respectively 36, 23, 9 and 7 min for DX, 4'EDX, 4'dxDX and 4DMDR. The three anthracycline derivatives, but not DX, significantly increased coronary resistance. Heart rate was reduced by all compounds compared with baseline, but not compared with controls. Rhythm disturbances were seen with all five hearts perfused with 4DMDR, which stopped beating before 40 min; 2/5 hearts in the 4'EDX group and 1/5 hearts in the 4'dxDX group also stopped before the end of perfusion. All the compounds reached concentrations in the myocardium 8 to 50 times higher than in the perfusing medium. The more cardiotoxic the compound, the higher was its myocardial concentration; a significant correlation was found for all four agents. Noradrenaline was never measurable in the perfusate of control and DX hearts; perfusion with the three anthracycline derivatives caused some release, but the pattern was not clearcut and the maximum concentrations attained in the perfusate were relatively low (less than or equal to 1.6 X 10(-9) M). In conclusion, in the rat isolated perfused heart, the early cardiotoxicity induced by equimolar concentrations of the three anthracycline compounds was greater than that induced by DX and was directly related to drug accumulation in the myocardium. Catecholamines do not seem to have a major role in the development of toxicity in this model.

Animals↗
PubMed1986

Antitumoral activity of the oxazaphosphorine derivative, mafosfamide-cyclohexylamine salt (ASTA 7557) on a murine ovarian reticular cell sarcoma and its subline resistant to cyclophosphamide.

The antitumor activity of mafosfamide (MFA), and its parent compound cyclophosphamide (CTX), was investigated against an ovarian reticular cell sarcoma growing i.m. in C57BI/6 mice (M5), which is very sensitive to CTX, and against a subline of this tumor (R16) resistant to CTX. MFA is the prototype of a class of oxazaphosphorines which do not require metabolic activation since under physiologic conditions they undergo rapid spontaneous hydrolyzation to the activated 4-hydroxyoxazaphosphorine and retain a spectrum of activity very similar to the parent compound. After a single dose (300 mg/kg X 1) or repeated low doses (100 mg/kg X 6) the antitumoral activity of MFA on the M5 tumor appeared comparable to or only slightly lower than CTX; the highest T/C value for median survival times was 167% in MFA-treated mice vs. 176% in the CTX group. MFA showed no activity against the R16 subline, thus indicating cross-resistance between the two drugs. Marked thickening of the glissonian capsule with compression of the lobular area of the liver, observed on i.p. administration of MFA, did not result in histopathologic abnormalities of the hepatic parenchyma. The therapeutic efficacy of MFA was similar with i.p. and the i.v. route. MFA may represent a good candidate to replace CTX in cases in which a compound acting per se, and not through metabolites, is preferred.

Animals↗
PubMed1986

Total gastrectomy in the treatment of adenocarcinoma of the cardia. Review of the results in 73 resected patients.

Between January 1, 1971, and December 31, 1978, 73 patients with adenocarcinoma of the cardia were treated by total gastrectomy with distal esophagectomy. The continuity of the alimentary tract was restored by esophagojejunostomy using a Roux-Y procedure in 32 patients and jejunal loop interposition in 41 patients. The early postoperative mortality rate was 18 percent. The overall 5 year survival rate was 26.7 percent, and the 5 year survival rate for stage I and II disease was 91.6 percent and 25 percent, respectively, whereas none of the stage III and IV patients survived more than 4 years. Fifty-eight percent of the patients without nodal involvement lived more than 5 years. The 5 year survival rate was only 9.3 percent in the presence of nodal metastases. Our 5 year survival rates suggest the value of elective total gastrectomy for stage I or II adenocarcinoma of the cardia. Jejunal loop interposition is a time-consuming but functionally superior procedure in comparison to other reconstructive procedures after total gastrectomy.

Adenocarcinoma↗