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Biomedical subjects

F Mosca

Publications and source records attributed to F Mosca.

At least 253 records · Page 14Linked to original sources
PubMed1994

[Preservation of the pylorus in duodenocephalopancreatectomy in pancreatic and periampullary carcinoma].

The aim of this retrospective study is to evaluate whether the pylorus preserving pancreatoduodenectomy (PPPD) is as safe as the standard Whipple's procedure (PD) in the treatment of pancreatic and periampullary cancer. Between January 1980 and December 1993, 473 patients with carcinoma of the head of the pancreas or periampullary region were admitted to the Department of General Surgery of Pisa University Hospital. 201 of these patients underwent pancreatoduodenectomy (115 ductal carcinoma, 61 periampullary cancer, 25 other neoplasms). In each group patients received a PPPD or a PD (ductal carcinoma 76 PPPD and 33 PD; periampullary cancer 46 PPPD and 15 PD). Overall, postoperative mortality rate for PPPD was 7.5% and for PD 8.9%, decreasing in the last 6 years to 3.2% (3 out of 92 consecutive cases). Variables examined were age, sex, T and N status, tumour stage, histological grade, residual tumour, cancer recurrence, death from recurrence and survival time. No patient was treated with antiblastic therapy. Survival times were estimated for both PPPD and PD using the Kaplan-Meier method and thereafter compared with each other using the Breslow and Mantel-Cox test. The 5-year survival rate in PPPD was 12.3% and 63.01% for ductal and periampullary carcinoma respectively. Survival time was not statistically different between PPPD and PD for both ductal and periampullary cancer. As regards pancreatic cancer, the presence of lymph node metastasis appeared to be a poor prognostic factor, even though it did not reach statistical significance (p = 0.075). In conclusion PPPD may be considered a valid surgical option even when dealing with pancreatic or periampullary cancer.

Adult↗
PubMed1993

Microalbuminuria is a marker of left ventricular hypertrophy but not hyperinsulinemia in nondiabetic atherosclerotic patients.

Microalbuminuria predicts cardiovascular events in diabetic and nondiabetic patients. For a better understanding of the physiopathological importance of microalbuminuria in atherosclerotic disease, we evaluated the relation between urinary albumin excretion and arterial blood pressure, left ventricular mass, insulin, and lipid levels. The studies were conducted in patients with atherosclerotic peripheral vascular disease. Urinary albumin excretion (studied by nephelometry; an average of triplicate collections from 8 PM to 8 AM), causal blood pressure, echocardiographic left ventricular mass index and wall thickness, plasma immunoreactive insulin and C-peptide (both basally and after a 75-g oral glucose load), blood lipids, and fibrinogen were studied in eight normal subjects and 20 nonobese, nondiabetic male patients with angiographically documented atherosclerotic peripheral vascular disease and preserved renal function, 12 of whom were either hypertensive or on antihypertensive treatment. Eight patients were microalbuminuric (urinary albumin > 20 micrograms/min) and 12 were not. Ankle-arm index and calf and foot transcutaneous oxygen tension were reduced in comparison with normal control subjects but superimposable between the two patient groups to indicate a comparable clinical progression of the vascular disease. In the microalbuminuric subjects, left ventricular mass index was greater, interventricular septum was thicker, and cardiac hypertrophy was more frequent than in nonmicroalbuminuric patients. The prevalence of hypertension tended to be greater and systolic blood pressure values were higher in the presence of microalbuminuria. Overall, a highly significant relation existed between urinary albumin excretion and left ventricular mass. Systolic blood pressure was greater and a history of arterial hypertension was more frequent among microalbuminurics, whereas diastolic blood pressure values showed a statistically significant correlation with both variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1993

Conjugation of benzoic acid with glycine in human liver and kidney: a study on the interindividual variability.

1. The rate of conjugation of benzoic acid with glycine was measured in the homogenates of 110 specimens of human liver and in 67 specimens of human renal cortex. 2. The assay for the formation of benzoyl glycine consisted of measuring the formation of benzoyl glycine from (14C) benzoic acid and glycine in the presence of coenzyme A and ATP. 3. In human liver, the mean (+/- SD) and coefficient of variation for the formation rate of benzoyl glycine were 254 +/- 90.5 nmol min-1 per g liver and 36%, respectively. There was a weak, but significant, negative correlation (r = -0.339, p < 0.001) between the rate of formation of benzoyl glycine and the liver donor's age. 4. In the human kidney, the rate of benzoyl glycine formation was normally distributed. The mean (+/- SD) and coefficient of variation were 321 +/- 99.3 nmol min-1 per g kidney and 31%, respectively. 5. These in vitro results are consistent with the view that the in vivo rate of conjugation of carboxylic acid with glycine varies among subjects and is normally distributed.

Adult↗
PubMed1993

Auditory middle latency responses in patients with intracranial space-occupying lesions.

Auditory middle latency responses (MLRs) and auditory brainstem responses (ABRs) were investigated pre- and postoperatively in three patients operated on of intracranial tumor (craniopharyngioma in cases 1 and 2, left-temporal cystic astrocytoma in case 3). In each case examined, preoperative MLRs were informative in evaluating the damage to supratentorial neural structures owing to the tumor; furthermore, they allowed a precious evaluation of the functional integrity of these structures after surgery. Likewise, in case 2 the ABRs indicated a brainstem injury secondary to overzealous manipulation of the right temporal lobe. Finally, in case 3, the most prominent complex of the MLRs, ie Na-Pa, was abnormal both before and after intervention; indeed, in pre- and postoperative MLRs, Na could be identified in both ears, whereas Pa was greatly reduced in amplitude or absent: this finding would seem to suggest that Na and Pa have different generator sites.

Adolescent↗
PubMed1992

[Esophageal achalasia: cardiomyotomy or pneumatic dilatation?].

Sixty-four patients with achalasia of the esophagus were surgically treated during the period 1973-1990. They were analyzed a late follow-up (mean = 78 months) by means of subjective and objective parameters. The Authors emphasize the efficiency of the diagnostic approach so that surgical treatment offers better results. The surgical technique of choice consists of an anterior esophagomyotomy (extending from 6 cm above the esophagogastric junction down to 1-2 cm below it) with the addition of an anterior Dor antireflux procedure through a laparotomy. The other therapeutic approach to achalasia is pneumatic dilatation of lower esophageal sphincter. A retrospective comparison of two different treatments is made through the analysis of the literature (medlars 1986-1990). Relief of dysphagia is reported in 92.78% of patients treated by myotomy and in 78.71% of those treated by forceful dilatation. The morbidity rate is greater after pneumatic dilatation (6% vs 5%) and the mortality rate is 1.1% after myotomy and 0.2% after dilatation. There are not rigorous criteria of choice between the two treatment methods but the Authors indicate that Heller's myotomy with an antireflux procedure achieve better and lasting results.

Adolescent↗
PubMed1992

Effect of kidney transplantation on quality of life measures.

Assessing the quality of life should be an essential part of the long-term results of surgery, particularly for those procedures that may influence a patient's lifestyle and body image. Eliminating the need for dependence on chronic hemodialysis, kidney transplantation improves the patient's autonomy but exposes them to the side-effects of immunosuppression and the constant threat of rejection. The purpose of this study was to compare the quality of life of patients on the waiting list for a kidney transplantation to that of those already transplanted at our Center to quantify carefully the impact of this therapy on the patient's physical, emotional, and social well-being. Computer analysis of the data collected from self-administered questionnaires revealed that the vast majority of successfully transplanted patients experience a significant improvement in almost all the areas investigated compared with the pretransplant group. In addition, we tried to use the questionnaire to predict which type of patient will adjust more fully to the impact of a kidney transplantation and which will probably need posttransplant psychological care and social support. Aside from clinical factors such as the time spent on hemodialysis before transplantation, the gender, the age, as well as the source of the organ (living vs. cadaver donor) seem to play a role in the final outcome of a successful kidney transplantation.

Adolescent↗
PubMed1992

Prenatal ultrasonography and early surgery for congenital cystic disease of the lung.

With the recent advent of prenatal ultrasound as a routine screening procedure, diagnosis of congenital cystic lung disease has been made in utero, raising the possibility of elective surgery for these lesions early in infancy before the patient develops respiratory distress or potentially life-threatening infection. From 1979 to 1989 six cases of congenital lung cyst were diagnosed in utero by prenatal ultrasound and followed during pregnancy. Two of the six were not confirmed after birth because the mothers preferred an abortion. The remaining four cases were studied periodically during gestation by ultrasonography. At birth, the first infant developed respiratory distress and underwent urgent left upper lobectomy and left lower segmentectomy at age 18 hours. The other three underwent elective lobectomy at age 10 days, 3 months, and 7 months, respectively. The fourth infant had a normal chest x-ray and ultrasound at birth, and the congenital cysts were confirmed by computed tomography scan. The pathological diagnosis in all four cases was cystic adenomatoid malformation. In two cases, intraoperative measurement of pulmonary function demonstrated significant improvement after resection of the affected lobe. We conclude that congenital lung cysts can be accurately diagnosed by prenatal ultrasound "screening" as early as 18 to 24 weeks' gestation. Advantages of early diagnosis include the option of moving the mother and unborn child to a high-risk obstetrical center for urgent operation on the newborn infant if necessary. Otherwise, once the diagnosis is confirmed, surgical correction can be performed electively and safely before respiratory distress or pulmonary infection complicates the infant's growth and development.

Cystic Adenomatoid Malformation of Lung, Congenita↗
PubMed1992

[The enzymatic activity of adenosine metabolism in the rat heart. The effects of cardiac hypertrophy].

The transmural distribution of the adenosine metabolizing enzyme activities 5'nucleotidase (5'N) and adenosine deaminase (ADA) across the left ventricular wall was explored in rats with heart hypertrophy induced by aortocaval shunt (FAC), or coarctation of the abdominal aorta (S) or by tireotoxicosis (T). FAC caused largest heart hypertrophy with a very short latency (1 day: + 0%, 3.5 days: + 30%, 7 days: + 41%, 21 days: + 49%). A 30% increase in the left ventricle free wall was observed after 3.5, 14 or 28 days of treatment with FAC, T or S respectively. Different changes in enzyme levels and alteration of transmural distribution profiles were observed with the different types of heart hypertrophy. Level of 5'N was decreased with FAC, did not change with T and increased with S; levels of ADA were always increased. The pattern of the transmural distribution of 5'N was affected by S but not by T and FAC, whereas distribution of ADA was not affected by S and T and was altered by FAC transiently.

Adenosine↗
PubMed1991

Sulphation of hydroxybiphenyls in human tissues.

1. Sulphotransferase is an important detoxication pathway of hydroxybiphenyls and the kinetics of sulphotransferase activity were studied in human liver, ileum and colon mucosae, lung, kidney, urinary bladder mucosa and brain using 0-, m- and p-hydroxybiphenyl as substrates. 2. Sulphotransferase activity was detectable in all tissues studied, although it showed marked tissue-dependence. The rate of sulphation ranged greater than 100-fold in different tissues and the highest and lowest activities of sulphotransferase were found in liver and brain, respectively. 3. The Km of sulphotransferase was not tissue-dependent but was dependent on the isomer of hydroxybiphenyl. The Km varied over a 500-fold range and the highest and lowest values of Km were found with p-hydroxybiphenyl and m-hydroxybiphenyl, respectively.

Adult↗