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Biomedical subjects

A Russo

Publications and source records attributed to A Russo.

864 records · Page 48Linked to original sources

[The use of an ultrasonic lithotripter during video laparoscopic cholecystectomy].

The video laparoscopic cholecystectomy, a new technique recently introduced in surgical surgery, includes, among other complications, also the dimension of stones. Our intention in the present work is to remove this limitation using an ultrasound lithotripter to reduce the dimension of lithiasic formations, avoiding, after all, to resort to minilaparotomy or to the use of dilators which are in contrast at least with two of the principles of methodology, the aesthetic and functional one for the patient.

Cholecystectomy, Laparoscopic↗

[Treatment results in pT2, NO1 breast cancer. )A retrospective analysis of 85 cases)].

The authors report on 85 T2 breast carcinoma treated from March 1984 to February 1991. The median age was 55.7 years (range: 24-82). The most common type of tumor was infiltrating ductal carcinoma (88.2%). T pathological diameter was in 69 cases < or = 3 cm (81.2%). 47 patients showed pathologically positive axillary nodes (55.3%). Radical mastectomy with total axillary dissection, preferably modified by Patey or Madden (78.8%), was the treatment of choice. Only 5 patients were submitted to conservative surgery (quadrantectomy plus radiotherapy). Mean follow-up time was 42 months. For all considered patients, crude and without evident disease 3 and 5 years actuarial survival was evaluated. Distant metastases were observed in a total of 12/85 patients (14.1%), mainly in N+ with more than 3 nodes (31.5%) three times associated to loco-regional failures. Results at June 1992, as occurrence of first failure from the date of surgery are described. Different therapeutic managements are discussed. Prognosis of T2 breast carcinoma remains still poor. Limited surgery in association with radiotherapy and/or pre- and postoperative chemotherapy in N+ patients with more than 3 nodes or N- patients with high cell proliferation index, seems to be encouraging to T2 cases with a diameter less than 3 cm, when local conditions are suitable for good final aesthetic results.

Adult↗

Immunocytochemical determination of estrogen and progesterone receptors and flow cytometric DNA analysis of breast cancer on fine needle aspirates.

A prospective study was performed on a series of 42 patients with breast carcinoma. Immunocytochemical determination of receptors for estrogens (ER) and progesterone (PR) and flow cytometric DNA analysis (DNA-ploidy and the S-phase fraction) were performed on material obtained from fine-needle aspirates (FNA). The patients underwent subsequent surgery, and the same parameters were determined on the surgical samples. The correlation between the biochemical and the immunocytochemical methods gave for ER, r = 0.853, p < 10 (-6) and for PR, r = 0.830, p < 1.6 (-6). In addition, comparisons of FNA's with the surgical samples showed significant relationships for the DNA index (r = 0.96, p < 0.000001) and for the S-phase fraction (r = 0.88, p < 0.000001).

Adult↗

Helicobacter pylori antibodies in areas of Italy at varying gastric cancer risk.

In a survey of 930 adults aged 35-74 years randomly sampled from the general population of four areas of Italy, two at low and two at high risk for gastric cancer, plasma levels of Helicobacter pylori IgG antibodies were assayed in order to investigate associations with the geographical distribution of gastric cancer and other dietary and life-style factors, as assessed by personal interview. H. pylori positivity (antibody titer above or equal to 10 micrograms/ml), 45% overall, increased with age and was inversely associated with social class but showed little geographical variation or association with dietary variables and blood nutrients. H. pylori positivity was also associated with increased blood levels of pepsinogens, particularly pepsinogen II. The authors discuss these findings in relation to those from a previous case-control study of gastric cancer in the same areas.

Adult↗

Intralaboratory reproducibility in cervical cytology. Results of the application of a 100-slide set.

In order to evaluate the agreement and accuracy of cervical (vaginal) cytologic diagnoses, 16 cytologists from a large laboratory in Florence, Italy, with experience ranging from 2 to 25 years, independently examined a set of 100 slides. A common reporting form based on a seven-category classification system was used. Concordance was calculated for each pairwise comparison between the 16 cytologists and between each cytologist and the target diagnosis. The values of the kappa statistic for the whole laboratory were .49 for the multiple raters comparison and .59 for the target diagnosis comparison, showing a relatively good degree of agreement.

Cervix Uteri↗

[Endometriosis of the abdominal wall. A report of a case secondary to cesarean section].

The Authors report a case of endometriosis of the surgical scar following caesarean section. The patient, arrived at surgical observation for a doubtful foreign body granuloma, underwent a diagnostic biopsy of the lesion. Histological examination confirmed the endometriosis nature of the lesion. Before surgical removal, adjuvant therapy based on GnRH analog was performed with the aim to reduce the volume of the lesion. After removal a cycle of therapy with GnRH analog was performed in oder to exclude possible residual pathologic microscopic lesions.

Abdominal Muscles↗

[Late radiation-induced injuries: breast carcinoma in post-actinic ulceration of the thoracic-breast region with infected osteoradionecrosis. A case report].

Severe skin reactions are commonly observed after breast irradiation. Chronic ulcerations, soft tissue damage and osteonecrosis are well-known though relatively rare long-term radiation-induced injuries. The ever-present possibility of recurrence or persistence of the primary malignant neoplasm within the irradiated tissue must be always suspected and adequately established by multiple biopsies before planning an eventual resective and or reconstructive strategy. In the present report a neoplastic recurrence arised from an extensive radiation-induced ulceration along the parasternal area with chest wall osteonecrosis complicated by infection in a 42 y.o. woman, who had received postoperative roentgen therapy a long time before for breast carcinoma and thyroid cancer, is described. Radiation-induced injuries and therapeutical options are discussed in relation to the site of the lesion and to the complexity of the single case. In conclusion, when recurrent malignancy is present, although the long-term prognosis may be poor, the quality of life of many patients undoubtedly may be improved by a multidisciplinary approach involving oncologysts, as well as general, thoracic and plastic surgeons.

Adenocarcinoma, Papillary↗

Biological characterization of laryngeal squamous-cell carcinoma.

The traditional prognostic factors, including stage of disease and tumour grade, have shown a limited prognostic significance and an inability to predict clinical response to specific treatment in patients with laryngeal squamous-cell carcinoma. More recent data suggest that cell kinetics indices, DNA-ploidy, lysosomal cysteine proteinase expression and genetic changes of both tumour suppressor genes and protooncogenes may be considered as reliable and reproducible indicators of biological aggressiveness in these patients. Moreover, the frequency of different genetic alterations suggests that several pathways are involved in the genesis of these neoplasias and, in particular, it is very probable that p-53 expression and PCNA indices (increased in normal mucosa and preinvasive lesions) may constitute more important biomarkers for the early steps of laryngeal carcinogenesis.

Cell Division↗

[Paget disease of the jaws. Review of the subject. Clinical-therapeutic considerations].

Clinical and diagnostic findings of Paget's disease of the jaws are reported; up to date etiological and pathogenical hypotheses are presented. Laboratory data of increased P.A. as a marker of disease evolution is pointed out, particularly the relationship increasing hydroxyprolinuria, because the increase of a malignant transformation. Surgery, always modeling, is limited to cases of severe facial dysmorphosis associated or not with the local disturbance due to compression; in any case it is suggested to perform the surgery in the phases of inactivity of disease, to avoid local complications, such as hemorrhage a infection.

Adolescent↗

[Health risks from infrared emissions from radiant tube heaters in the workplace].

With the exception of domestic rooms, Overhead Radiant Tube Heaters (ORTH) are an effective system for indoor heating (e.g. warehouses, factories, garage workshops, shipyards, greenhouses, schools hall etc.). The growing number of units installed is due to several advantages, such as uniform heating, absence of air movements, energy saving, versatility and safety. Indoor heating is obtained by an infrared emission, which is produced by the circulation of combustion exhaust gases within tubes and is collected by a set of reflecting surfaces located around the tubes. In the present communication, the attention is driven on the characteristics of ORTH infrared emissions, with reference to potential health risks for the exposed people (especially people working within areas heated by this system). A reason for this is represented by the existence of a specific italian regulation (Circolare N. 1322/4134-28.01.1992, Direzione Generale della Protezione Civile-Ministero dell'Interno). Following the last one, ORTH surface temperatures resulting in a spectral emission which includes wavelengths less than 3 microns have to be considered, in the case of ORTHs with thermal power greater than 34.89 kW, as hazardous for exposed people. Although the ORTHs emission spectrum partially covers the near infrared region (0.8-1.4 microns) at 400 degrees Celsius and may adversely affect the retained tissue a gross evaluation of the near infrared energetic flux, weightened on the surface unit, allows to exclude this risk. On the opposite, the results of the same evaluation carried out in the medium and far infrared spectral region at 200 degrees-400 degrees Celsius (the normal temperature range for ORTHs) do not allow to preliminary exclude a thermal risk for eye structures such as lens, near the tube surface at least. In every case, a burn hazard for both corneal tissue and skin is excluded. With the aim to carry out a detailed set of radiometric estimates, some preliminary considerations are furnished concerning the risk assessment for the eye, with reference to the following parameters: emission spectrum, energetic flux, workstation, presence of reflecting surfaces, potential interferences, exposure duration, angle between the incident radiation on eye surface and the optic axis. ACGIH 1992/93 for infrared radiation TLVs are followed as reference standard.

Environmental Exposure↗

[Iatrogenic lesion of the thoracic duct in the neck. Presentation of a case].

Authors report a case of iatrogenic lesion of thoracic duct of the neck occurred during clearing the left latero-cervical zone for thyroid cancer. After reporting the relative unusuality of this complication, authors underline that in the literature there are always more frequent reports about lymphatic lesions in every district of the body due to more aggressive treatments. Although this case has been treated with a relatively simple operation (finding and binding the duct), treatment of these lesions is not always so simple and therefore knowledge of metabolic problems of these disorders, as well as the selection of the surgical strategy, should be always carefully evaluated for recovery of this disease.

Carcinoma↗

[Bilateral aneurysms of the popliteal artery].

INTRODUCTION: Popliteal artery aneurysms are the most common of peripheral arterial aneurysms. Popliteal aneurysms are bilateral in 42% of patients. Atherosclerosis and bacterial invasion of the arterial wall are the predominant etiologic factors of popliteal artery aneurysms. CLINICAL CASE: A male of 67 years old was referred to our institution for bilateral claudication and 150 m. free interval. The angiogram showed a partial occluded aneurysm of the right popliteal artery and a complete thrombosis of the left popliteal artery aneurysms. The left aneurysm was resected and a femoral popliteal by-pass was performed, using the inverted saphenous vein graft, associated with left lumbar sympathectomy. Six months later the contralateral aneurysm was excised and a Dacron femoro-popliteal by-pass graft was performed. Two years later Arteriographic and Doppler examination showed patent by-pass bilaterally. CONCLUSION: Popliteal artery aneurysms can be a threaten for the lower limbs, because of thromboembolic phenomena and occasional rupture. Surgery is the best treatment before the appearance of an acute complication and a by-pass with an autogenous vein graft or a Dacron graft are the most common surgical procedures performed. Thrombolytic therapy offers good results where an acute complication appears.

Aged↗

The influence of amalgam fillings on urinary mercury excretion in subjects from Apulia (southern Italy).

The purpose of this study was to assess the role of dental amalgams and diet upon urinary mercury (U-Hg) excretion. 98 subjects (50 men and 48 women) not exposed to inorganic mercury, for either occupational or environmental reasons, and living in coastal and inland districts of Apulia (Southern Italy) were considered. All the subjects were administered a questionnaire with questions concerning life style, medical history, and occupational activity. Dental amalgams were evaluated with respect to their number and their surface areas. Urinary mercury was measured by the cold vapour atomic absorption technique. Expressed in terms of arithmetic mean, U-Hg excretion was found to amount to 1.03 micrograms/g creatinine (5th and 95th percentile: 0.31 and 2.40; range 0.30-3.25). Multiple linear regression analysis showed that, of the several tested independent variables (dental amalgams, age, body mass index, consumption of tuna, bass, swordfish, etc.), only the number of amalgam fillings (T = 5.25; p = 0.025) and the number of restored surfaces (T = 2.33; p = 0.020) were found liable to affect urinary mercury excretion in a significant manner. In conclusion, the results of this study confirm the primary role of amalgam fillings in affecting urinary mercury excretion in those subjects who are not occupationally exposed to inorganic mercury, The resulting urinary mercury levels can no doubt be taken as the reference values for the population of Apulia.

Adolescent↗

[Deep parotidectomy with conservation of pre-neural tissue in the surgery for Warthin tumor].

The perfect acquaintance of the surgical anatomy of the parotid region associated to the rigid execution of the operative times by now standardized for the interventions on the parotid gland, they constitute a solid base of certainty on which found the own surgical choices. In some cases it's possible going away from the established rules to follow the impulses that the personal instinct suggests in the attempt of overcome unusual technical difficulty. The case in examination constitutes the tangible example to this enunciated, in which the technical difficulty of a neoplastic subneural bulk--the comfort on whose benignity arose from a preoperative FNAB (often but not always secure on the real histological nature)--that it could not be enucleated without dissect the trunk of the facial nerve, it imposed the adoption of technical extemporaneous solutions which, since dictate from the necessity of the moment, must not be recommended like rules to follow in all the situations, neither judged as rash surgical choices.

Female↗

[Epidermoid carcinoma of the thyroid].

About thyroid neoplasms the epidermoidal carcinoma represents an ingrown minority (0.3-0.74%). Several etiopathological hypotheses are considered and this testifies the notable uncertainty that still winds the origin of the neoplasm. In the actual case, the more accredited hypothesis foresees the origin of the neoplasm from a histopathological of Hashimotos' tyhroiditis. The objectivity of the case in examination constitutes the clinical picture of reference of the malignant neoplasms of the thyroid: oligosintomatic low cervical mass of increased consistence, adherent to the imminent pianos strictly following laryngeal movements, dysfagia and dysfonia. Additionally they were present pulmonary and right cervical lymphonodal metastases. After an adjuvant treatment with Paraplatin and 5-FU, to some months from the intervention of total thyroidectomy, local relapse in form of a festered mass is highlighted in sovrajugular region with result in cutaneous-esophagustracheal fistula. The diagnosis of certainty of the neoplasm, despite the rarity, it doesn't constitute a problem, albeit the percents of survival, anyway substantially more favorable respect to anaplastic neoplasms, concerning to as numerical as chronological aspects, result to be hardly discouraging.

Aged↗

Prognostic significance of proliferative activity, DNA-ploidy, p53 and Ki-ras point mutations in colorectal liver metastases.

Paired colorectal liver metastases (CLM) and normal tissue samples from a consecutive series of 36 patients were studied prospectively. MIB-1 expression was studied by immunohistochemistry on paraffin-embedded sections. DNA ploidy and S-phase fraction (SPF) measurements were performed by flow cytometry on frozen tissues. Mutations within the p53 (exons 5-8) and c-Ki-ras (codons 12 and 13) genes were detected by PCR single-strand conformation polymorphism analysis followed by sequencing. A high correlation was observed between the MIB-1 LI and SPF value (rho=0.81; P<0.01). Moreover, p53 gene mutations were associated with either high MIB-1 LI and high SPF. In univariate analysis, SPF and MIB-1 levels were related to risk of death. The association between overall survival and DNA-ploidy or p53 mutations did not reach statistical significance, but a slightly better survival was observed for patients either with DNA-diploid tumours or without mutations (P=0.05 and P=0.06, respectively). SPF was shown by multivariate Cox model analysis to be an independent prognostic variable and thus it might be a useful prognostic factor in patients with CLM.

Adult↗

Nm23-H1 protein, DNA-ploidy and S-phase fraction in relation to overall survival and disease free survival in transitional cell carcinoma of the bladder.

OBJECTIVES: To explain the overall survival (OS) and disease free survival (DFS) in relation to nm23-H1 protein, DNA-ploidy and S-phase fraction (SPF) in transitional cell carcinoma of the bladder. PATIENTS AND METHODS: Ninety-four samples were obtained from patients with transitional cell carcinoma of the bladder examined between 1994 and 1996. The patients were underwent cistectomy or surgical biopsy and the material was histologically evaluated according to World Health Organization classification. Nm23-H1 protein expression in immunohistological staining and DNA ploidy, S-phase fraction by flow cytometric were performed. RESULTS: The correlation between OS and staging, grading, DNA-ploidy and S-phase was significant; whereas the overall survival and nm23-H1 protein, was not significant. The relationship between DFS and stage, DNA-ploidy and S-phase had a significant value. The correlation between DFS and age, sex, grading and nm23-H1 protein was not significant. There was no significant difference in age, sex, stage, grading, DNA-ploidy and SPF distribution between patients with nm23-H1 positive bladder cancer and those with nm23-H1 negative tumours. CONCLUSION: In our study, multivariate analysis showed that stage, ploidy and SPF were the strongest prognostic factors in predicting disease-free survival and prolonged survival, while nm23-H1 expression was not related to disease progression and/or prolonged survival. This expression, therefore, does not appear to be an independent prognostic factor in bladder cancer, although a still larger number of patients and a longer follow-up period are now needed for a definitive assessment of the prognostic significance of nm23-H1 expression.

Adult↗