Biomedical subjects
Publications and source records attributed to E Porta.
Large silicone stents (9-28 French) were placed in the biliary tree of 173 patients over a 3-year period. Their use markedly reduced the incidence of catheter occlusion and sepsis. Only three cases of cholangitis and one case each of excessive bleeding and pleural effusion occurred. No skin irritation or pancreatitis occurred. The large bore of the catheter and the use of biocompatible material improved the safety and efficacy of biliary drainage.
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Transverse myelitis after a zoster viral infection is an exceptional occurrence. In this case we documented an antibody activity against varicella zoster (V-Z) in the cerebrospinal fluid in association with Coxsackie A enterovirus. The clinical course was atypical because of a second episode of myelitis 2 years after the first episode of neurologic viral complications. The positive outcome of therapy with Acyclovir is noteworthy. This case was retrieved in a review of neurologic complications observed in the last few years in patient affected by zoster in our hospital.
15 chronic cluster headache patients in whom pain was induced by nitroglycerin received acute intravenous treatment with a calcium entry blocker. At the time of peak pain we noted a sudden decrease after the Verapamil injection. The mechanism by which the calcium entry blocker afforded relief is unlikely to have been vasodilatation in patients whose blood vessels had just been dilated by nitroglycerin. A more probable mechanism is blockade of the release of the pain-inducing neurotransmitters. The vasodilatation phase is not a primary factor in the onset of pain.
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The authors describe the use of preoperative embolization of glomus tumors in 7 patients. In two cases a nonresorbable substance (IBCA) was used for the embolization, and no subsequent operation was needed. They therefore suggest that embolization could be a definitive treatment and an alternative to surgery.
It is argued, on the grounds of earlier findings, that the neural substrate of egocentric space representation has analogue (non-symbolic) topo-topical properties. It is then argued from fresh evidence that space representation appears to be anchored to the sagittal midplane of the trunk and to the line of sight. A tentative reduction of the suggested properties of space representation to the neuro-physiological level is briefly outlined.
One hundred thirteen children referred for chronic constipation were examined by means of diagnostic work-up including anal inspection, rectal exploration, weekly bowel frequency evaluation, measurement of total and segmental intestinal transit times (TITT, SITT), contrast enema, anorectal manometry (ARM), suction rectal biopsy for histochemistry. Final diagnosis were: chronic functional "simple" constipation in 53 children; chronic functional constipation and soiling in 32; Hirschsprung's disease in 18. In 10 children, initially referred for constipation, TITT was in the normal range so they underwent no further examination. Conclusions are that bowel frequency identifies a real gastrointestinal problem, but definite diagnosis of constipation is relied on TITT. In the assessment of chronic constipation nature, ARM is more sensitive than radiology. Suction rectal biopsy is reliable in detection of aganglionosis: its accuracy can be improved by histochemical or biochemical determination of Acetylcholinoesterase.
Erythrocyte glutathione peroxidase (GSH-Px) was assayed in subjects of Mediterranean origin and the distribution of the data obtained seems to confirm the existence of two alleles coding for low and high enzyme activity. In order to define the limits of expected genotypes less arbitrarily we studied families where parents' genotypes could allow us to define that of the children. Gene frequencies were calculated from genotype frequencies of an unrelated population and from crossings distribution by the Hardy-Weinberg equation. We observed a good agreement between gene frequencies obtained by these two different methods.
Percutaneous transluminal angioplasty for treatment of renovascular hypertension was performed on 63 patients during a 5 years period. No compliance related to this procedure set in. At follow-up, the clinical results were shown to be positive in 85.7% of the cases.
In our Department a yearly screening is carried out on the school population of Milan, in order to detect beta-thalassaemic trait carriers and G-6-P-D deficient males. This report deals with the results obtained on a group of 21,118 males. They all showed very low enzyme activity and often just detectable; the fall of GSH after incubation with acetylphenhylhidrazine appeared significantly greater than normal. Only 3 cases of hemolytic crises by fava beans ingestion and 7 cases of neonatal jaundice resulted from anamnestic data.
The utility of the preoperative embolization of glomus tumors observed in 7 cases is reported. Two patient have been embolized with non reabsorbable materials and haven't been operated. The possibility of a definitive embolizing therapy as alternative to a surgical treatment is therefore supposed.
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The Authors verified the diagnostic incremental data furnished by computerized tomography in respect to traditional tomography in assessing and staging lung cancer. This comparative study was based on eight diagnostic parameters, analysed in 150 strongly suspected patients. It is concluded that computerized tomography allows to give a very accurate judgement about the stage of the cancer, reducing the need of diagnostic thoracotomies.
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The authors compared the diagnostic accuracy of pharmacologic double contrast, conventional barium meal and oesophago-gastro-duodenoscopy of the stomach in 922 selected patients. The agreement rate between conventional investigation and endoscopy was 70.3%, while it was 83.7% between double contrast studies and endoscopy. Double contrast false positives percentage (48.7%) is bigger than that for conventional technique (38.3%), whilst the latter has a much bigger number of false negatives, both absolutely (169 cases) and relatively (61.7%). Furthermore the association of double contrast and endoscopy was compared with the anatomo-pathological diagnosis in 335 cases. The agreement rate was 94.6%.
A case of hypereosinophilic syndrome showed clinical and hemodynamic signs of Löffler's endomyocardiopathy. The case is peculiar because of the young age, the early diagnosis, the lack of clinical and hemodynamic signs of heart failure. Some peculiarities: an apical diastolic murmur and a diastolic pulmonary capillaries/left ventricle pressure gradient recalled the picture of mitral stenosis, but the echocardiographic pattern of mitral valve was normal; a sistolic aortic and pulmonary subvalvular gradient, with an increase in ventricular wall thickness, was present. Echocardiography, systolic time intervals, and maxdp/dt and Vmax showed a very good left ventricular function. The patient is still in good compensation, with unchanged clinical pattern and eosinophilia, despite the therapeutical attempt with corticosteroids and antiallergic drugs, after one year from the diagnosis. The pathogenetic hypothesis of this cardiac and hematologic disorder are discussed.