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Biomedical subjects

A Perulli

Publications and source records attributed to A Perulli.

5 recordsLinked to original sources

[Transvaginal echocystourethrography].

The anatomo-physiologic appearances of female urination obtained with a new ultrasonographic technique is illustrated. The technique is performed using an intravisceral linear probe positioned in the vagina and a special chair which allows the urination in physiological position; at the same time the urination is videorecorded. The results, compared with X-Ray cystourethrography, enabled us to show the normal aspects (both dynamic and morphologic) and several pathologic aspects. Basing upon the direction of the urethra, it is possible to establish the change of the position of the floor and the neck bladder, which are often responsible of stress incontinence. The Authors stress the relative simplicity and noninvasiveness of the echographic technique. X-Ray radiation aren't used: this test is particularly advisable to study the urination disease of women in fertile-age.

Adult↗

[Comparative analysis of the technics of preoperative localization of the parathyroid glands].

Parathyroid surgery needs an appropriate diagnosis and a preoperative localization. We conducted a prospective study to compare the efficacy of 4 different imaging modalities in 17 patients: thallium-technetium subtraction scintigraphy, ultrasonography, computed tomography and arteriography. The sensitivity was: scintigraphy 58%, echotomography 86%, Tc 92% and arteriography only 33%. Neck exploration confirmed the imaging results. We found 15 cases of adenomas (2 cases of double adenoma) and 1 case of hyperplasia; in 1 patient, no lesions were found. We conclude that the association of such techniques appears to be the optimal strategy in about 100% of the patients.

Adenoma↗

[Local excision of rectal cancer in early phase as an alternative to major surgery].

The authors analyse the role of local excision as curative procedure of low rectal early cancer. In their opinion it's very important to select the patients in accordance with some characteristics of the tumor (site, grading, mobility, depth, size, stage, involvement of locoregional nodes, ploidia). Intrarectal ultrasonography is thought be the most important diagnostic tool, both in preoperative diagnosis and in postoperative follow-up; it has a high sensibility to define the parietal invasion of rectal cancer and to recognize metastatic nodes. They review various surgical techniques used to make local excision by several authors (transsacral approach by Kraske, transsphinteric approach by Mason and transanal approach by Bailey), as well as the alternative methods (surgical diathermy by Strauss, endocavitary irradiation by Papillon and cryosurgery by Heberer). The authors point out the technique of Bailey and coll. is getting the major approvals owing to its simplicity, low mortality and morbidity rates, poor incidence of recurrences and good survival. The most recent therapeutic protocols provide only local excision for the lesions limited into mucosa and submucosa (stage T1), also postoperative radio- and chemotherapy for tumors involving muscolaris propria (stage T2). On the other hand, advanced rectal cancer (stage T3) may be managed best by major operations. Recurrences rates (5-22%) and five-years survival rates (78-90%) are obviously conditioned by tumor features. Finally, the authors reaffirm, with their personal experience as well, the importance of local excision as curative operation for low rectal early cancer, provided that a careful case selection is made in accordance with macro- and microscopical features of the tumor.

Aged↗

The schwannoma: an uncommon type of cystic lesion of the pancreas.

Schwannomas of the pancreas are rare and their number is lower than is usually reported in the literature since some were probably neurofibromas. We report a further case characterized by cystic feature, clinically mimicking a pancreatic pseudocyst. Cystic lesions of the pancreas also comprise the schwannomas, both benign or malignant, as has been previously reported and is stressed by the present case. Cyst formation characterizes many diseases of the pancreas, both neoplastic and not. Difficulties in the differential diagnosis of cysts are fortunately reduced by the preponderance of pseudocysts (i.e. non-neoplastic cysts) and, among neoplastic ones, of cystadenomas and cystadenocarcinomas. As a consequence, uncommon cystic neoplasms are neglected and very often misdiagnosed. We reported a case of solitary schwannoma mimicking a pancreatic pseudocyst, interesting both because of its rarity and because of its cystic feature which was previously reported in the literature but not emphasized.

Aged↗