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Biomedical subjects

D Franco

Publications and source records attributed to D Franco.

249 records · Page 14Linked to original sources
PubMedDate not supplied

Surgery for cholangiocarcinoma.

Cholangiocarcinoma is a cancer arising from bile duct epithelium and commonly occurs in the main bile duct or at the bile duct confluence. The patients present obstructive jaundice and often have advanced disease. Treatment in the past has frequently consisted of palliative measures aimed at relieving jaundice either by surgical bypass or by endoscopic or percutaneous drainage usually in combination with stenting. A better understanding of the ways of invasion of the pathology of cholangiocarcinoma together with improvements in surgical techniques and perioperative management have lead to an increase in the number of patients in whom resection may be contemplated. Resection offers the only chance of cure and the best chance of long-term survival. Current problems associated with resection of hilar cholangiocarcinoma are discussed in this review article.

Bile Duct Neoplasms↗
PubMedDate not supplied

Surgical treatment of small hepatocellular carcinomas in cirrhosis.

Over the last five years a policy of systematic screening for small hepatocellular carcinomas (HCC) in patients at risk has led to an increasing number of resections in patients with cirrhosis. Remarkable progress in the surgery of HCC in cirrhosis has been accomplished through: (a) a better understanding of the surgical anatomy of the liver, (b) the definition of new types of liver resection aimed at reducing the amount of parenchyma removed while still being oncologically satisfactory, (c) the reduction of intraoperative blood loss by various techniques of clamping afferent and efferent vessels, (d) the systematic use of intraoperative ultrasonography, and (e) the prevention of postoperative variceal bleeding and the formation of ascites. Results of resection of small HCC in cirrhosis have been quite impressive in Japanese series, with a low operative mortality and above 50% three-year survivals. Results in the West have been somewhat less good. Differences in the pathology of these tumours and particularly in the rate of encapsulation could account for these differences. Clearly, surgical resection has become an established treatment for small HCC in cirrhosis. More information is needed on the results of surgery in operated patients and this should be compared with the natural history of small HCC in cirrhosis in order to better define the patients who will most benefit from these operations and which tests performed at which intervals, are most reliable in screening patients at risk.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

[The problem of caustic poisoning in children].

The exposure to caustic substances in childhood, being accidental in most cases, can cause doubts in the initial diagnostic therapeutic approach; the risk of missing lesions following caustic ingestion when symptoms are scarce or lacking is high. The paper provides an overview of the physiopathology and clinical presentation of caustic injuries and stress the possibility of burns of esophagus and/or stomach even without oropharyngeal symptoms and/or signs. The esophagogastroduodenoscopy has now an essential role in the evaluation of gastrointestinal tract injury, as a guide to the therapy and as a prognostic criterion. So it is possible to reduce the risk of poor outcomes by the appropriate treatment. Anyway the primary prevention against the exposition to caustic substances at home is fundamental and must be effected both through active and passive measures.

Adolescent↗
PubMedDate not supplied

[Study of the risk of analgesic-antipyretic drugs in children].

Poisonings by analgesic-antipyretic drugs in childhood in our country need specific prevention measures because of their incidence and clinical severity. We analysed the clinical-epidemiologic data of 114 cases of poisonings in children under 16 years of age and the results of a questionnaire answered by 507 adults to identify risks factors. The most of these poisonings happened at home; the esposition was accidental in younger children, even if it often depended from therapeutic mishaps; it was more frequently voluntary at the age of 10. Disinformation on risks and lack of appropriate store in the house are the main factors. The prevention therefore must be based either on the education and the use of safe child resistant containers, besides other passive preventive measures.

Accident Prevention↗
PubMedDate not supplied

Management of colorectal cancer in patients with cirrhosis and a LeVeen shunt.

Two cirrhotic patients with a LeVeen shunt presented with a large bowel cancer. In one patient, the shunt was removed and the venous catheter was ligated prior to the performance of a colon resection. The postoperative course was uneventful. A new valve was inserted and connected to the venous catheter two months later. The second patient had a carcinoma of the rectum. In order to prevent ascites and to ease the colorectal resection he had preliminary construction of a portacaval shunt. Six weeks later, he underwent an anterior resection of the rectum. The postoperative course was uneventful except for a self limiting episode of febrile subacute intestinal obstruction. These two cases demonstrate that it is possible to resect colorectal cancer in patients with cirrhosis, ascites and a peritoneovenous shunt provided measures are taken to avoid specific complications due to the presence of the shunt, ascites or portal hypertension.

Aged↗
PubMedDate not supplied

[Study of venous distensibility using plethysmography with venous occlusion in post-phlebitic syndromes].

Venous distensibility has been studied in the cases of twelve patients presenting a post-phlebitic syndrome, compared with five patients with primary varicose veins. In the post-phlebitic syndromes we note far fewer symptoms of venous distensibility, whereas in the cases of varicose veins there is an increase of venous distensibility. Statistics of the delta V max. 50 and the symptoms of distensibility are given in a recapitulatory table, and a diagram.

Humans↗
PubMedDate not supplied

Carcinosarcoma of the liver with mesenchymal differentiation: a case report.

Carcinosarcoma of the liver with mesenchymal differentiation are very rare in adult patients. A case is reported with an exhaustive pathologic examination and review of the literature. A 61-year old man presented with general fatigue and dull abdominal pain. Two liver masses were diagnosed and resected by a right hepatectomy. Specimen pathology revealed that the tumor and lymph node consisted of two cancerous components. One carcinomatous component corresponding to a hepatocellular carcinoma and a sarcomatous component characterized by a diffuse proliferation of spindle shaped cells with chondrosarcomatous and osteosarcomatous changes. Patient died 9 months later of a diffusion of the tumor. For the first time, to our knowledge, a mesenchymal differentiation is demonstrated in liver carcinosarcoma.

Carcinoma, Hepatocellular↗