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Biomedical subjects

F Carli

Publications and source records attributed to F Carli.

120 records · Page 7Linked to original sources
PubMedDate not supplied

Leiomyosarcoma of the broad ligament: a case report and review of literature.

Leiomyosarcoma of the broad ligament is a rare tumor, since only 12 cases have been reported so far in the literature. A 53-year-old patient was diagnosed with leiomyosarcoma of the broad ligament at the Department of Gynecology Oncology of the National Cancer Research Institute in Genoa. The tumor had low mitotic activity and less than ten mitotic figures were found for ten high-power fields. The treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy with bilateral ureteral neoanastomosis and omentectomy. The patient has not received either radiotherapy or chemotherapy, considering the low grade of malignancy, but she is only followed up on an outpatient basis. No evidence of metastasis has been noted after a follow-up of 13 months. It is concluded that low-grade leiomyosarcoma of the broad ligament should be treated only with surgery.

Broad Ligament↗
PubMedDate not supplied

Mapping the sentinel lymph node in malignant melanoma by blue dye, lymphoscintigraphy and intraoperative gamma probe.

Eighty-eight consecutive patients (48 men and 40 women; mean age, 58.9 years; range, 16-84 years) with clinically localized cutaneous melanoma involving the trunk, extremities or head and neck underwent lymphatic mapping at our institution. The primary melanoma had a mean thickness of 2.74 mm (range, 0.95 to 9 mm). Patients were divided into two groups: group A (39 patients) underwent only vital blue dye (VBD) mapping, while group B (49 patients) underwent lymphatic mapping with VBD and radio-guided surgery (RGS) combined. In all patients 1-1.5 mL of VBD was injected subdermally around the biopsy scar 10-20 min before surgery. In group B 37 MBq in 150 microL of 99mTc-HSA nanocolloid was additionally injected intradermally 18 h before surgery (3-6 aliquots injected perilesionally). In all lymphatic basins where drainage was noted the sentinel lymph nodes (SNs) were identified and marked with a cutaneous marker. Final identification of the SN was then performed externally by a hand-held gamma probe. After the induction of anesthesia 0.5-1-0 mL of patent blue V dye was injected intradermally with a 25-gauge needle around the site of the primary melanoma. SNs were examined by routine hematoxylin and eosin (H&E) staining and immunohistochemistry. Patients with histologically positive SN(s) underwent standard lymph node dissection (SLND) in the involved lymph node basin. The SN was identified in 37/39 patients (94.9%) of group A and in 48/49 patients (98.0%) of group B. Blue dye mapping failed to identify the SN in 5 of the 88 patients (5.8%), while the radioisotope method failed in only 1 of 49 patients (2.0%). Similar results were obtained with the combined use of the two probes. The average number of SNs harvested was 1.9 per basin sampled, which does not differ significantly from the numbers reported by other authors. The SN was histologically positive in 18 patients (20.5%). None of the 12 patients with a Breslow thickness less than 1.5 mm had positive SNs, whereas 18 of the 77 patients (23.4%) with a Breslow index exceeding 1.5 mm showed metastatic SNs with H&E or immunohistochemistry. The latter all underwent SLND of the affected basin. In 10 patients (55.6%) the SN was the only site of tumor invasion; eight patients (44.4%) with positive SNs had one or more metastatic lymph nodes in the draining basin.

Adolescent↗
PubMedDate not supplied

Fundus angiography with fluorescein-labelled peptide fraction from bovine factor VIII: correlation with histologic findings.

A peptide fraction (VUEFFE) obtained from bovine factor VIII, with a high affinity for vessel endothelium, was bound to fluorescein and used for angiography in rabbits. Several eyes had undergone laser photocoagulation on the retina. The location of the dye was studied histologically with fluorescence microscopy on the enucleated, freeze-dried eyes. The angiographic and histologic findings were compared with findings obtained using sodium fluorescein. Fluorescein-labelled VUEFFE gave a longer lasting fluorescence of the retinal vessels with histologic evidence of dye deposition on the vessel wall. It also showed marked affinity for the photocoagulated tissues, giving intense and prolonged staining of the laser burns. Possible clinical applications are discussed.

Amino Acid Sequence↗
PubMedDate not supplied

[Pathology of adrenal glands and hypophysis in AIDS].

More than 50% of AIDS patients show adrenal compromise. The major pathological findings include inflammatory changes of both the cortical and medullary portion with necrosis and haemorrhage. The principal determinant of these abnormalities appears to be CMV infection. We also report the occurrence of focal or subtotal hypophyseal necrosis in the setting of AIDS. These alterations of endocrine glands may deserve attention in the management of the patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Continuous spinal anesthesia: dose requirements and characteristics of the block.

BACKGROUND AND OBJECTIVES: A fine-bore 28G CoSpan spinal catheter was used to provide continuous spinal anesthesia for major upper and lower abdominal, peripheral vascular, and orthopedic surgery in 90 patients, aged 31-91 years. METHODS: Initial doses (0.5-2.0 mL) of hyperbaric bupivacaine 0.5% were given and followed, if needed, by additional doses of 0.5-1.0 mL to achieve a satisfactory blockade for the proposed type of surgery. The incidence of hypotension, ambulatory postdural puncture headache, and technical problems encountered with insertion of the spinal catheters were recorded. RESULTS: The technique of continuous spinal anesthesia was successful and easy to learn. Satisfactory sensory and motor blockade was achieved within 12-18 minutes, and surprisingly small amounts were needed in those patients undergoing limb surgery. CONCLUSIONS: Mild postdural puncture headache occurred in four patients, but none of the patients required blood patch. One catheter broke during removal; since then, it has been our policy to remove a catheter with the patient in a flexed position.

Abdomen↗
PubMedDate not supplied

Preoperative spinal bupivacaine does not reduce postoperative morphine requirement in women undergoing total abdominal hysterectomy.

BACKGROUND AND OBJECTIVES: This study was undertaken to determine whether preoperative spinal anesthesia with local anesthetics would exert a pre-emptive effect on postoperative analgesia by reducing neural afferent stimulation. METHODS: The authors studied 38 healthy women undergoing total abdominal hysterectomy. Patients were randomly allocated to two groups: group A received a spinal block (T3-S5) prior to induction of anesthesia and surgery, while in group B the block was performed after surgery prior to extubation of the trachea. Patient-controlled analgesia morphine was administered to both groups during the first 24 postoperative hours. RESULTS: Pain and sedation scores at 6, 12, and 24 hours were similar in the two groups. Cumulative morphine consumption at 6 and 24 hours after surgery was similar in both groups; however at 12 hours more morphine was needed in group A (P < .02). CONCLUSIONS: The authors were unable to demonstrate that spinal block with bupivacaine before surgery, as opposed to after surgery, decreased the requirement of morphine in the postoperative period.

Adult↗
PubMedDate not supplied

Modulation of protein metabolism in the surgical patient. Effect of 48-hour continuous epidural block with local anesthetics on leucine kinetics.

BACKGROUND AND OBJECTIVES: To quantitate the possible nitrogen-sparing effect induced by continuous epidural block during the flow phase of surgical trauma, protein kinetics were measured in patients undergoing colorectal surgery and receiving a constant protein intake. METHODS: Epidural block was established in two groups of eight patients each before surgery with 0.75% bupivacaine, and after surgery sensory analgesia (T4 to S5) was maintained with 0.25% bupivacaine. In the first group, the neural block was maintained for 24 hours, while in the second group, it was maintained for 48 hours. Protein synthesis and breakdown and amino acid oxidation were measured by a stable isotope dilution technique using a primed constant infusion of labeled leucine. Changes in oxygen consumption (VO2) and carbon dioxide production (VCO2) were estimated by indirect calorimetry. RESULTS: All measurement were made before and 2 and 4 days after surgery. Whole body protein synthesis and breakdown and VO2 and VCO2 increased significantly (P < .05) in the 24-hour group after surgery compared with presurgical levels during the second postoperative day. In contrast, no significant increase was found in the 48-hour group, which had an effective neural block during the isotope infusion. On the fourth postoperative day, whole body protein metabolism was similar in both groups. CONCLUSIONS: Direct application of isotope tracer methodology to acute studies confirms the beneficial effects of epidural block with local anesthetics in modulating body nitrogen losses.

Aged↗