[The previsional validity of the glycerol test in evaluation of therapy of Meniere's disease].
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Adult↗
Biomedical subjects
F Mosca
Publications and source records attributed to F Mosca.
Visualization of a bronchobiliary fistula during cholescintigraphy with 99mTc-diethyl-IDA.
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Biliary Fistula↗
[Intestinal lymphangiectasis: late complication of transportation of the great vessels corrected by the Mustard technic. A clinical case].
The Great Arteries Transposition corrected by Mustard's repair is often complicated with inferior vena cava obstruction with consequent intestinal lymphangiectasia and protein-losing enteropathy. We report a case of a 9 years old boy who underwent Mustard's repair and presented diarrhoea, abdominal pain, hypoproteinemia and ascites. The fecal elimination of 51Cr-labeled albumin was remarkable increased and the intestinal biopsy showed a noteworthy lymphangiectasia due to an hemodynamic overload. Therefore subjects with Great Arteries Transposition corrected by Mustard's repair should be valued in the post-surgical follow-up by 51Cr-labeled albumin fecal elimination and by intestinal biopsy, already sensitive in asymptomatic phase.
Child↗
[Diagnostic problems in mediastinal goiter].
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Angiography↗
[Testicular biopsy in the study of male sterility].
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Biopsy↗
[Familial neoplasms: investigation of genealogic trees of patients surgically treated for colonic adenocarcinoma].
In order to study the familial aggregation of colorectal cancer we investigated the pedigrees of the patients with adenocarcinoma of the large bowel who underwent a surgical operation between november 1990 and october 1992 at the Istituto di Chirurgia Generale e Sperimentale Of Pisa University. For each proband, information was obtained on his/her four grandparents and all their second generation descendants. The final sample included 99 probands and 1455 relatives. Only two cases with diagnosis of familial adenomatous polyposis were excluded. As a control group, we applied the same methodology to the spouses of probands, collecting in the end a sample of 72 families including 1163 individuals. The frequency of both colorectal and extracolonic cancer was higher in the relatives of cases than in the control group, for all the relationships. Among the first degree relatives, the empirical risk of colorectal cancer was 1/30 among the case families and 1/139 among the control families, for a 4.6 fold increase in risk. For cancers at all sites (colorectal excluded), the corresponding risk were 1/8 and 1/12. We computed the posterior probability of dying from cancer for a random individual, given the known affection status of one or more of his/her relatives of specified relationship. For an individual with one first degree relative affected by colorectal cancer the posterior risk of the same tumor was 1/15, compared to a value of 1/70 for the entire control population. Considering all cancers, colorectal excluded, we obtained the result that for a person with at least three affected relatives, one of first, one of second and one of third degree, the probability of dying from colorectal cancer was 6%. The distribution of the number of affected individuals for kindred was highly skewed, with a few families responsible of a large part of the observed familial aggregation. This was true for both the cases of colorectal cancer and for all-site cancer. However, no family fulfilled the criterion of hereditary nonpolyposis colorectal cancer (Lynch syndromes I or II).
Adenocarcinoma↗
[Cervical electrostimulation in some vestibular diseases].
Vestibular disorders may be treated by means of drugs, surgical tools or rehabilitation. Cervical electrostimulation may be regarded as physical therapy and its activity is connected to neural pathways between cervical receptors and vestibular nuclei. In present study electrodes were placed lateral to cervical column on the opposite side of vestibular deficit as pointed by electronystagmography; stimulus duration was 18 msec and frequency 100 Hz. Every stimulation lasts for 30 minutes and were repeated twice a week for a total number of 10. The ability to adjust vestibulo-ocular reflex was evaluated by means of a Compensatory Index. The following materials were enrolled in the study: 20 normal subjects were observed before and after a cycle of stimulations: 24 patients suffering from acute labyrinthitis or neuritis, 48 cervical vertigo, 8 cervical traumatic injures and 3 patients operated for acoustical neuroma. All these groups were coupled with control groups composed of the same pathology and the same number of subjects. Statistical treatment of reports was evaluated by t-student test before therapy after one month and after 3 months. Results point out good effects of electrostimulation on vestibulo-ocular reflex compensation, especially in cervical vertigo and labyrinthitis or neuritis with respect to control groups. No important results were obtained in neuroma group and in normal subjects. Electrostimulation may act on vestibular nuclei by direct spino-vestibular pathway but also by repeated decompensations mainly mediated via the cerebellum or spino-reticular connections.
Electric Stimulation Therapy↗
Exclusively aortic cold flushing for liver procurement from hemodynamically stable donors. An experimental study in the pig.
Liver cooling before grafting is usually achieved by aortic plus portal flushing; exclusively aortic flushing is reserved to hemodynamically unstable or non heart-beating donors. We have compared the effects of "aortic plus portal" (8 cases) and "aortic" (8 cases) cold flushing on the early function of pig liver grafts from hemodynamically stable donors. The time for liver removal (mean +/- standard deviation) was 30.4 +/- 7.1 min. in the "aortic plus portal" and 19.7 +/- 3.3 min. in the "aortic" group (p < 0.01). All the recipients survived for at least 72 hrs; only those of the "aortic plus portal" group showed some degree of primary liver dysfunction; recipient serum aspartate transaminase (AST) was significantly higher in the "aortic plus portal" than the "aortic" group. Since aortic flushing allowed for shorter operation times and was better tolerated than and at least as effective as aortic plus portal flushing, it can be proposed for routine liver procurement even from hemodynamically stable donors.
Animals↗
[A rare association: antral neurinoma with gastric volvulus].
The paper describes a very rare case of obstructing antral neurinoma with associated gastric volvulus. Pathogenetic mechanism of this association, which has never been reported in the literature, is discussed. The authors also focus their attention on the diagnostic difficulties and the choice of therapy. A hiatoplasty and a Billroth II gastrectomy were performed in the described case.
Aged↗
Giant pedunculated liposarcomas of the esophagus: literature review and case report.
Although liposarcoma is the second most common soft-tissue sarcoma in adults, its incidence within the gastrointestinal tract is distinctly low. Esophageal involvement is exceedingly rare and only four cases have been described so far. A fifth case is presented here along with a thorough review of the literature of polypoid lipomatous tumors of the esophagus. Diagnostic and therapeutical strategies of these tumors are discussed in detail.
Diagnosis, Differential↗
Surviving catastrophic gastrointestinal involvement due to Churg-Strauss syndrome: report of a case.
Gastrointestinal (GI) involvement is not rarely encountered in Churg-Strauss syndrome (CSS). We describe the case of a young white woman presenting with acute acalculous cholecystitis, who subsequently developed, despite prompt administration of immunosuppressive therapy, life threatening GI involvement, requiring multiple operations. Over a 7-month period the patient eventually recovered from her disease. Forty-two months later she is free from symptoms, with low daily doses (6 mg) of oral methylprednisolone. Although medical and surgical complications of CSS may develop while the patient is undergoing therapy, early diagnosis with joint surgical and medical management is essential to bring the disease under control.
Acute Disease↗
Pancreatic cancer and tumor markers: role of the newly identified CAR-3 antigen.
BACKGROUND AND AIM: The aim of this study is to assess the clinical usefulness of the serum assay for CAR-3 in the diagnosis and follow-up of pancreatic cancer. MATERIALS AND METHODS: Serum levels of tumor markers (CAR-3, Ca 19.9, Ca 195 and CEA) were measured in a total of 238 patients with various diseases of the gastrointestinal (GI) tract, including 61 pancreatic cancers. Cut-off levels were calculated on the basis of a non-parametric estimate of 90% specificity. After surgery, patients with pancreatic cancer underwent a combined serological and radiological (CT-scan) follow-up. RESULTS: At the cut-off level of 6.15 U/L, the sensitivity of CAR-3 was 62.3% (CA 19.9: 77%; Ca 195: 75.4%; CEA: 24.5%). In the differential diagnosis between pancreatic cancer and other GI diseases, significant differences were found. No association was discovered either between serum level of tumor markers and tumor stage or between short- and long-term survivors. In the follow-up, CT-scan was superior to serologic tests (sensitivity: 94.2%). Among tumor markers, CAR-3 achieved a sensitivity of 62.5% (Ca 19.9: 83.3%; Ca 195: 75%). DISCUSSION: CAR-3 is shed in the circulating stream in a much lower proportion of cases than that observed for antigen expression at immunohistochemistry. During the follow-up CT-scan was the most accurate diagnostic tool. However, the meagre therapeutical options for recurrent pancreatic cancer, do not justify such an aggressive follow-up. CONCLUSIONS: Ca 19.9 remains the tumor marker of choice for either the pre-operative work-up or the post-surgical follow-up of patients with pancreatic cancer.
Antigens, Tumor-Associated, Carbohydrate↗
[A rare case of acute abdomen: perforated acute diverticulitis of the cecum].
The Authors report a rare case of perforated diverticulitis of the cecum. The patient was a 68-year-old man who was referred to the Authors attention with the classic symptoms of acute appendicitis. During laparotomy a perforated "omentum-sealed" diverticulum was found on the lateral wall of the cecum, whereas the appendix appeared to be completed unaffected. A right hemicolectomy was performed. The Authors analyse the similarities and peculiarity of the case. Special attention is drawn to the problems of differential diagnosis raised by this pathology. A preoperative diagnosis is arduous because the disease is difficult to distinguish from acute appendicitis and may be even difficult to distinguish it intraoperatively from a carcinoma of the cecum. There is no characteristic clinical pattern pointing to this diagnosis. Diagnostic maneuvers are usually unrewarding. Right hemicolectomy is a safe procedure when the diagnosis is doubtful.
Abdomen, Acute↗
[Hartmann's procedure in colorectal tumors. Evolutions of the indications in a series of 46 patients].
The Authors report a retrospective study of 46 cases of Hartmann's operation in order to analyze the changing indications to this procedure in the management of colo-rectal cancer. The Hartmann's is operation has been performed in 46 out of 723 patients (6.4%) with colorectal cancer treated surgically from 1973 to 1997. Data concerning the indications have been analyzed in two consecutive periods, from 1973 to 1985 and from 1986 to 1997, respectively. In the first period, the procedure has been performed in patients with neoplastic perforation (40% of Hartmann's cases), and in an elective basis in patients with locally invasive tumor or intra-abdominal metastasis (20%). Indications for the procedure in the period 1986-1997 have been locally invasive tumor and/or distant metastasis (52.8% of Hartmann's procedures), neoplastic perforation (22.2%), high surgical anaesthesiologic risk (22.2%) or intestinal obstruction (2.8%). In the second period it has been noted a decrease of the number of patients that underwent Hartmann's procedure for bowel obstruction, and an increase in the number of cases in which the operation was performed for neoplastic perforation, for local and/or distant diffusion, or for high surgical risk.
Aged↗
[Synchronous primary carcinoma of the colon. Diagnostic and therapeutic problems].
Seven hundred and twenty-three patients with colorectal carcinoma were treated consecutively from November 1973 to April 1997. Seven patients (0.96%) were found to have two colorectal carcinomas (synchronous carcinoma), located in separated colonic areas. Clinical histories were analyzed with reference to sex, age, symptoms, physical findings, disease localization, pathologic classification, and survival data. Preoperative diagnosis of synchronous lesions is difficult, being achieved in only 2 cases, but it is important for the proper treatment of patients. It is concluded that full examination of the colon in all patients presenting with primary colorectal cancer is mandatory and that colonoscopy should be used to effectively screen patients for synchronous cancers.
Adult↗
[Self-expanding stents for the palliation of esophageal and gastric cardia cancer].
Twenty-one endoscopic tube implantations were carried out in 24 patients with malignant stenosis of esophagus and gastric cardia using self-expanding metallic stents. The indications to endoscopic intubation were advanced stage of the tumor in 17 cases and risk factors which made resection inadvisable in 7 cases. In 3 patients it proved impossible to implant a stent endoscopically because the Authors were not able to pass the guide wire through the stenosis, while correct stent placement was achieved in 21 patients. Functional results were good in 18 patients, while 3 patients did not have any improvement of symptoms. Complications occurred in 9 patients (42.85%): 2 bleedings, 3 neoplastic obstructions, 1 food obstruction and 3 distal dislodgements of the prostheses were observed, but could readily be corrected. No death occurred. The median survival time was 151 days (range 25-545). This study suggests that endoscopic placement of metallic self-expanding stents is safe and has to be preferred to plastic stents for easier implantation and lower morbidity.
Aged↗