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Biomedical subjects

A Schillaci

Publications and source records attributed to A Schillaci.

At least 19 recordsLinked to original sources
PubMed2002

Computed tomographic colonography (virtual colonoscopy): blinded prospective comparison with conventional colonoscopy for the detection of colorectal neoplasia.

BACKGROUND AND STUDY AIMS: Computed tomographic colonography (CTC), also known as virtual colonoscopy, is a recently introduced imaging modality for the detection of colorectal neoplasia. The aim of our study was to evaluate the performance of CTC in a blinded comparison with conventional colonoscopy. PATIENTS AND METHODS: A total of 66 consecutive, symptomatic patients underwent spiral computed tomography (CT) examination after standard bowel preparation. CT images were analyzed and subsequently compared with conventional colonoscopy findings. RESULTS: Conventional colonoscopy detected 15 colorectal carcinomas and 52 polyps. CTC correctly identified all carcinomas, 13 of 14 polyps greater than 10.0 mm (sensitivity 92.8 %; 95 % confidence interval (95 % CI); 77 - 100), 11 of 13 polyps between 6.0 and 9.0 mm (sensitivity 84.6 %; 95 % CI; 62 - 100), and six of 25 polyps smaller than 5.0 mm (sensitivity 24 %; 95 % CI; 6 - 42). The per-patient sensitivity and specificity were 93.7 % and 94.1 %, respectively. CONCLUSIONS: Computed tomographic colonography is an accurate imaging modality for the detection of colorectal neoplasia, especially for lesions larger than 6.0 mm in diameter.

Adult↗
PubMed2000

Internal investigations: a proactive approach to compliance.

Healthcare financial managers increasingly are recognizing that internal investigations can uncover and help correct improper activities before they attract government attention, as well as reveal valuable facts about any questionable activities that may be the target of a government inquiry. An organization that exhibits a high level of responsibility by undertaking a thorough internal investigation of possible improper activities may reduce or eliminate civil or criminal sanctions the government can impose if the organization is found guilty of improprieties. Furthermore, an internal investigation can preserve the organization's integrity and reaffirm its commitment to high ethical standards and sound business practices.

Ethics, Institutional↗
PubMed1998

Compliance crunch.

The U.S. Department of Justice is showing no mercy in its campaign against what it calls "fraud and abuse" in Medicare billing. Here's what you can do to keep the wolf from coming through your door.

Communication↗
PubMed1996

[Caroli's disease: 2 case reports and review of the literature].

The most appropriate management of Caroli's disease is still controversial: in fact many surgical modalities have been proposed for patients exhibiting cholangitis or intrahepatic lithiasis, but these approaches have been seldom performed on asymptomatic or oligosymptomatic patients. However, this figure, due to the surgical risk related with a bilio-enteric anastomosis or with an hepatic resection, should be always compared with the possible development of a cholangiocarcinoma within the enlarged biliary tree (7%), as clearly shown in the 2 cases herein reported.

Adult↗
PubMed1993

The importance of heterogeneity and of multiple site sampling in the prospective determination of deoxyribonucleic acid flow cytometry.

Multiple fresh specimens from 59 nonsmall cell carcinomas of the lung, 38 carcinomas of the gastric tract and 55 carcinomas of the colon and rectum were analyzed by deoxyribonucleic acid (DNA) flow cytometry (FC) after radical resection to evaluate tumor ploidy as an independent prognostic factor. The minimum follow-up period was five years (range of five to ten years). Aneuploidy was observed in 98.0 percent of carcinomas of the lung, in 70.9 percent of carcinomas of the colon and rectum and in 63.1 percent of carcinomas of the gastric tract. FC DNA heterogeneity, in terms of different number of DNA stem lines or different DNA indices between core and periphery, or both, was found in 50.0 percent of carcinomas of the lung, 47.0 percent of carcinomas of the colon and rectum and in 34.5 percent of carcinomas of the gastric tract. A diploid pattern was more frequently observed in less advanced stages of the gastrointestinal tract. By univariate analysis (Kaplan-Meier), patients with carcinoma of the lung with hypodiploid or hypertetraploid peaks, or both, and aneuploid gastric tumors had poorer prognosis. These differences were only marginally significant. Cox analysis demonstrated that the single most important prognostic variable for predicting the overall survival rate was the stage of disease. Tumor DNA content can be considered a marker of advanced stages, particularly in tumors of the gastrointestinal tract, but there is no evidence that it is an independent prognostic variable able to predict long term survival in patients who have been radically resected.

Adenocarcinoma↗
PubMed1991

[Surgery by exeresis for gastric carcinoma. An analysis of 165 consecutive cases].

Surgery is still considered the best approach in gastric cancer. The aim of this study was to identify the most important factors involved in the determination of long-term survival. Total and subtotal gastrectomy were analysed. Long-term survival in these patients was strictly correlated with the stage of disease and the infiltration of resection margins. Early diagnosis is confirmed to be the most important factor in the long-term survival of these patients.

Carcinoma↗
PubMed1990

[Prognostic factors in stomach cancer: invasion of gastric serosa and lymph node involvement].

Concerning prognostic factors in gastric cancer, the Authors analyse the main two influencing long-term prognosis: the depth of penetration of the tumor in the gastric wall and the presence of lymph node metastasis. 194 operated gastric neoplasms were staged, according to TNM classification (U.I.C.C., 1987) and divided into 4 groups: in the first group both the serosa and the lymph nodes were tumor-free; in the second both were involved; in the third only lymph nodes were involved; in the fourth only the serosa was involved. Crossed statistic analysis between groups showed that the only factor that influenced the long-term survival is the node involvement in the patients with tumor-free gastric serosa. These results correspond to most of the others in literature, and point to the connection between these two factors in defining the stage of the disease.

Female↗
PubMed1990

Flow cytometric analysis in colorectal carcinoma: prognostic significance of cellular DNA content.

The prognostic value of DNA ploidy status was evaluated prospectively in 70 patients with colorectal carcinoma. Cellular DNA content was measured by flow cytometry from fresh specimens with multiple site sampling. Seventy-five percent of cases exhibited a DNA aneuploid pattern. In a univariate analysis, DNA ploidy status showed a statistically significant correlation with survival (p less than 0.05), weaker than Dukes' stage (p less than 0.001). No correlation was observed between survival and presence of multiple DNA stemlines. In a multivariate analysis, Dukes' stage was the strongest prognostic indicator (p = 0.01) while DNA ploidy status did not show an independent prognostic value. It is concluded that DNA ploidy status is associated with pathological features of aggressive malignancy, but it does not have a determinant role in predicting survival.

Adenocarcinoma↗
PubMed1988

Early gastric cancer.

A clear difference in survival among the patients affected by gastric cancer has been observed worldwide between Early Gastric Cancer (EGC) and Advanced Gastric Cancer (AGC). Optical fiber endoscopy has allowed a sharp increase in the number of diagnoses of EGC since the sixties. Among 182 our patients operated on, 19 [10.4%] had an EGC. A difference in incidence was found between males and females, while no difference was found in the age distribution. The main symptom was epigastric pain; EGCS common findings were ulceration or a flat tumor. Surgical procedures were carried out with the same criteria used for AGC. No difference was found in the tumor location. Local spread was studied according to the Japanese Research Society for Gastric Cancer, while histological type was classified according to Lauren classification. Crude 5-year survival was 80% (8 out of 10), with a mean of 76.8 +/- 13 (SEM) months.

Female↗
PubMed1987

Intrarectal ultrasonography in the preoperative staging of rectal cancer.

Intrarectal ultrasonography is a new imaging method used in the preoperative staging of rectal cancer. Twenty five patients with proven rectal cancer were submitted to preoperative intrarectal ultrasonography; 24 were resected. Real time scanner with a linear probe of 5 MHz was employed. Five sonographic structures corresponding to the five histological layers were evidenced. Ultrasound T staging was compared to pathology, using UICC classification. In all but two cases pathology corresponded to ultrasound T staging (accuracy 92%). Perirectal nodal involvement was also investigated. It is concluded that intrarectal ultrasonography will play a definite role in the preoperative staging as well as in programming treatment of rectal carcinoma.

Adult↗
PubMed1984

Diagnosing metastases of differentiated thyroid carcinoma with 201 thallium scan: a case report.

A case of supraclavicular metastatic follicular carcinoma which occurred 7 years after the patient had undergone total thyroidectomy is presented. By means of whole body 210-thallium scan, a precise diagnosis was made, while the whole body 131-I scan was negative. The thyroglobulin serum levels were high before surgery but significantly decreased after lymphadenectomy. The clinical use of this tracer to detect functioning and non-functioning metastases of thyroid carcinomas is discussed.

Adenocarcinoma↗
PubMed1984

The importance of symptom duration in relation to prognosis of carcinoma of the large intestine.

Between 1971 and 1982, 162 patients underwent surgical treatment for carcinoma of the large intestine; follow-up data was available for 94 per cent of the patients. Tumor stage distribution was homogeneous and did not differ significantly with increasing duration of symptoms. The duration of symptoms was not determinant of survival, whereas stage influenced survival. These results show that patients with carcinoma of the large intestine with a short symptomatic period do not have either less advanced tumors or better survival prospects.

Colonic Neoplasms↗