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Biomedical subjects

A Persi

Publications and source records attributed to A Persi.

At least 19 recordsLinked to original sources

[Laparoscopic treatment of liver hydatid cyst: personal technique].

Treatment of liver hydatid cyst is still controversial. Besides medical treatment, interventional radiologic techniques and traditional surgery, recently the laparoscopic approach has been proposed. Laparoscopic treatment of liver hydatid cyst, however, has not been well defined so far and seems to be associated with a recurrence rate from 0 to 9%, in a 3-49 months follow-up. Disadvantages of the laparoscopic approach are difficult control of spillage, peritoneal dissemination of parasites and incomplete aspiration of high density fluid contents of the cyst. The authors have reviewed the literature and describe a personal technique to avoid this disadvantage and to reduce postoperative recurrence rate.

Echinococcosis, Hepatic↗

Comparative retrospective study on the use of plastic prostheses and self-expanding metal stents in the palliative treatment of malignant strictures of the esophagus and cardia.

Palliative treatment of malignant strictures of the esophagus and cardia is usually carried out by the endoscopic placement of a prosthesis. The aim of this retrospective study was to evaluate short- and long-term outcomes of the use of expandable stents, compared with conventional plastic prostheses. One hundred and thirteen endoscopic intubations were carried out in 120 patients affected by malignant stenosis of the esophagus and cardia using plastic prosthesis and self-expanding metal stents. Dysphagia was scored according to Atkinson and Ferguson's classification and the preoperative median score (3.6) was comparable in both groups. The technical success rate was 94.4% with plastic prosthesis and 93.7% with self-expanding metal stent while the functional success rate was, respectively, 85.2% and 88.8%. Three deaths occurred with plastic prostheses (4.4%), while no deaths were observed with metal stents. A comparative analysis of the results of this study suggests that the endoscopic placement of self-expanding metal stents is effective and safe and has to be preferred to the conventional plastic prosthesis for easier implantation and lower morbidity.

Adenocarcinoma↗

[Gastric stromal tumors. Our experience in 21 cases surgically managed].

BACKGROUND: A retrospective review on 21 patients with gastric stromal tumors who underwent surgical treatment in the period 1974-2001, is presented. METHODS: The patients were 8 males and 13 females, with an average age of 62.6 years. Histological examination showed 15 smooth muscle tumors (9 benign and 6 malignant), 5 neural tumours (3 benign and 2 malignant) and 1 undifferentiated tumor. Main symptoms were abdominal pain and palpable abdominal mass and the most sensible diagnostic techniques were endoscopy and abdominal CT-scan. Surgical procedures performed were: local resection (15 cases), partial gastric resection (3 cases), subtotal gastrectomy (2 cases) and total gastrectomy (1 case). RESULTS: There were no operative mortality and morbidity. Among 12 patients with benign GSTs, 1 died for causes not related to the disease, while 11 patients are still alive and in good health after a mean follow-up of 148.5 months (range 6-262). Among patients with malignant muscular GSTs, 3 were lost to follow-up and 3 are alive and free from disease after a median follow-up of 58 months (range 3-108). The 2 patients with malignant neural GSTs are still alive and in good health 140 and 24 months after surgical procedure, while the patient with undifferentiated GST died for liver metastases 43 months after total gastrectomy. CONCLUSIONS: The authors conclude that the most frequent symptoms are abdominal pain and a palpable mass, but no specific signs have been detected. Endoscopy plays a very important diagnostic role and CT-scan is the most sensible technique in the evaluation of location, size, invasion of adjacent organs and metastasis. The aim of treatment must be the complete resection of the tumor and the prognostic prediction on the basis of histologic findings is quite difficult.

Aged↗

[Gastric diverticulum. A case report with long-term follow-up and a review of the literature].

A rare case of symptomatic gastric diverticulum surgically managed is reported. The pathogenetic and clinical aspects of the disease are discussed and the usefulness of endoscopy as a means for differentiation between medical and surgical cases is stressed. A review of the literature is made and the conclusion is drawn that this uncommon pathology is often asymptomatic and requires surgical management only in complicated cases and in symptomatic patients that are not responding to medical treatment, as showed by the long-term follow-up (333 months) of the reported case.

Diverticulum, Stomach↗

[Helicobacter pylori and gastric cancer. The incidence of infection in personal experience].

BACKGROUND: Helicobacter pylori is an identified carcinogen for gastric cancer, but the underlying mechanisms remain to be defined. The aim of this study is to analyze the incidence of Hp infection in our series of patients with gastric carcinoma. METHODS: Between 1988 and 1998, 60 patients with diagnosis of gastric adenocarcinoma underwent partial or total gastrectomy. Forty-one were males and 19 females with an average age of 62 years (range 36-79). Twenty-seven cancers (45%) were localized in the lower third of the stomach, 17 (28%) in the middle third and eight (13%) in the upper third or cardias. In six patients (10%) the tumor was multicentric, while a recurrence on gastric stump after subtotal gastrectomy was present in two cases (3%). According to Lauren's criteria 39 cancers (65%) were of intestinal type, 16 (27%) of diffuse type and five (8%) of mixed type. The histologic preparations have been re-examined in order to verify the presence or not of Hp on gastric mucosa around neoplasm. RESULTS: Hp was found in 35 (58%) of the analyzed specimens and therefore a significant percentage of patients was Hp-positive at the time of diagnosis and surgery. Between 35 Hp-positive samples, 24 were adenocarcinomas of intestinal type, nine of diffuse type and two of mixed type, with a prevalence of Hp in intestinal type cancer. CONCLUSIONS: This study confirmed the high incidence of Hp infection in patients with gastric carcinoma, particularly in those with intestinal type cancer.

Adenocarcinoma↗

[Pancreatic pseudocysts. Our experience with 21 cases treated surgically].

Twenty-one consecutive patients with pancreatic pseudocyst have been reviewed. Nine cases have been treated with internal drainage, 9 with external drainage, while 3 patients have undergone distal pancreatectomy. No mortality was associated to the surgical treatment, while morbidity was of 9.5% due to pancreatic fistulas. Based on their own experience and literature review the Authors describe clinical, diagnostic and therapeutic features of the disease and point out the good results of cistojejunostomy with Roux-en-Y loop.

Adult↗

Impairment of vitamin A uptake by rat hepatocytes and fat storing cells determined by Monensin--morphological observations.

The action of the Na+/H+ antiport monensin on vitamin A uptake by rat liver has been studied in vivo. The quickfading autofluorescence of vitamin A has been used for the determination of vitamin A uptake by the liver. Pretreatment of rats intraperitoneally with monensin decreases the uptake of vitamin A by hepatocytes and its transfer for storage to fat storing cells. Pretreatment of rats intraperitoneally with vitamin A for a short time, then with monensin, shows that the hepatocytes no longer transfer vitamin A to fat storing cells for storage. These results might indicate that monensin impairs the uptake of vitamin A by the hepatocytes and might also impair the transport of vitamin A from parenchymal to perisinusoidal cells.

Adipocytes↗

[Multibacillary atypical mycobacteriosis].

A case of atypical multibacillary mycobacteriosis is described. The differential diagnosis is discussed on the basis of clinical, microbiological and histopathological parameters.

Adolescent↗

[Anti-nDNA antibodies in lupus erythematosus].

Using the ELISA technique we have tested anti-nDNA antibodies in 79 patients affected with Lupus Erythematosus. The same patients have previously been tested for anti-cardiolipin antibodies. According to the literature, cross inhibition ELISA tests show no cross reactions between these two auto-antibodies families. Patients with highest anti-nDNA antibodies show a production of polyclonal (IgG, IgM, IgA) antinuclear antibodies responsible for a homogeneous pattern detected by indirect immunofluorescence.

Adult↗

Metronidazole and Demodex folliculorum.

In vitro survival of Demodex folliculorum was tested in the presence of various concentrations of metronidazole (Flagyl). Demodex was found to survive in concentrations of as much as 1 mg/ml. Thus, it seems unlikely that the effect of metronidazole on rosacea is attributable to its direct activity on the mite.

Hair↗

[Malignant stromal tumors of the duodenum. Report of a case].

The Authors report a rare case of undifferentiated duodenal malignant stromal tumour in a 69-years-old man radically managed by pancreaticoduodenectomy and resection of a liver metastasis. Several preoperative tests were performed (barium meal, endoscopy, ultrasonography and CT scan) but failed to yield a differential diagnosis between a tumour of the pancreatic head and a retroperitoneal neoplasm. The diagnosis was only histological. The tumour was considered to be high-grade due to its large size, high mitotic index, and the presence of necrosis and liver metastasis. Thorough surveillance revealed several hepatic metastases 29 months after resection, and chemotherapy performed at this stage proved completely ineffective. The patient died 38 months after surgery.

Aged↗

[Multiple primary malignant neoplasms. Report of a rare case with 5 metachronous tumors].

The Authors report on a patient admitted several times for the occurrence of five multiple metachronous primary malignancies (laryngeal carcinoma, endometrial adenocarcinoma, rectal cancerous polyp, ampulla of Vater carcinoma and transverse colon cancer). All five carcinomas were independent primary cancers, and the lengthy time intervals between the onsets of the individual tumours supports their independent non-metastatic origin. Classification, pathogenesis, genetic and environmental interactions of multiple tumours are discussed. In the case reported, a family history of colon cancer was present, while no genetic marker abnormalities or chronic exposure to carcinogens were found. The case report shows that an aggressive, appropriate surgical approach together with thorough follow-up monitoring offers a chance of long-term survival for patients with metachronous malignant primary tumours.

Ampulla of Vater↗