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Biomedical subjects

G Colella

Publications and source records attributed to G Colella.

At least 55 records · Page 3Linked to original sources

[A clinical case of primary malignant melanoma of the oral cavity].

A rare case of primary malignant melanoma of the oral cavity is reported and a literature review of etiopathogenesis, biological bases and prognosis is made. The hypotheses to explain the very severe prognosis of malignant melanoma of the oral cavity with respect to that of skin are discussed. The therapeutic approaches are described as well as the frequent difficulty to perform them in relation to the anatomical region and the wide extension of the tumoral lesion.

Aged↗

[A case of parotidomegaly associated with eating disorders (anorexia/bulimia)].

A case of parotidomegaly associated with anorexia is described, and the psychoneurological and etiopathogenetic theories of main feed disorders (anorexia/bulimia) are discussed. Particularly, a rare pathology of maxillofacial interest is presented: parotidomegaly associated with anorexia. The diagnosis and differential diagnosis of this pathology is discussed.

Adult↗

Hepatic adenoma and focal nodular hyperplasia: diagnosis and criteria for treatment.

UNLABELLED: Focal nodular hyperplasia (FNH) and adenoma are rare benign hepatic tumors, and the standards for diagnosis and treatment still remain controversial. Usually adenoma is an indication for resection, due to its tendency to bleed and to degenerate; FNH, on the contrary, may be treated conservatively. Preoperation differential diagnosis is, however, difficult, often impossible. MATERIALS AND METHODS: Thirty-eight patients with presumed hepatic adenoma and/or FNH were studied at our department from 1984 to 1996. Preoperative assessment included clinical evaluation and symptoms, laboratory tests, liver biopsy, ultrasound scan, computed tomography scan, magnetic resonance imaging, scintigraphy, and angiography. Thirteen patients had a presumed diagnosis of FNH, 16 of adenoma, and 9 of undetermined benign lesions; 27 had hepatic resections (3 with laparoscopic technique), and 11 were not operated on and are actually under a strict follow-up observation. RESULTS: The final diagnosis was 19 FNH and 19 adenomas (2 of which contained areas of hepatocarcinoma). Presumed diagnosis was confirmed in 71% of cases. Use of oral contraceptives, abdominal symptoms, and pathologic liver test results were frequent in patients with adenomas. There were no deaths after surgery. All resected patients were tumor free during the follow-up, and in 10 of the 11 nonoperated cases, the size of the nodules remained unchanged. We conclude that precise diagnosis of these benign liver tumors remains difficult and sometimes impossible, despite new imaging techniques. Hepatic resections can be performed under very safe conditions; laparoscopic surgery may play a role in selected cases. Adenomas and uncertain cases are clear indications for surgery. Only when a diagnosis of FNH can be firmly confirmed in asymptomatic patients is strict observation without surgery recommended.

Adenoma↗

Lactate blood levels in the perioperative period of orthotopic liver transplantation.

To investigate whether early postoperative changes in blood lactate concentration indicate the functional recovery of the newly grafted liver, changes in oxygen supply, oxygen consumption, acid-base equilibrium, and blood lactate concentrations were prospectively studied in a group of 53 postnecrotic cirrhotic patients during the various phases of orthotopic liver transplantation (preanhepatic, anhepatic, neohepatic) and for the first 48 h following reperfusion. The patients were divided into two groups according to the quality of the early graft function, as indicated by alanine aminotransferase, bile flow, and prothrombin activity: group A (49 patients), good immediate graft function and group B (4 patients), immediate graft non-function. Lactate levels rose in the same manner during the preanhepatic and anhepatic stages and peaked after revascularization of the graft. Following reperfusion, however, distinctly different blood lactate profiles were recorded in the two groups of patients. A fall in lactate concentration was recorded in group A patients, whereas a continuous rise occurred in group B patients: the difference becoming significant by the end of surgery (P < or = 0.05). During the first 48 h following revascularization of the graft, opposite trends in lactate concentration, bile flow, alanine aminotransferase, and prothrombin activity were evident in the two groups of patients: 24 h after reperfusion, lactate levels were below 2 mmol/l in 47 of 49 patients from group A, while they plateaued above 4 mmol/l in all patients from group B. Group A patients had lower alanine aminotransferase levels (P < or = 0.001), higher prothrombin activity, (P < or = 0.01), and greater bile flow (P < or = 0.02). If validated in larger series, the blood lactate profile, probably more than the absolute level, appears to be a useful indicator of the early recovery of liver metabolic capacities in the immediate postoperative period of orthotopic liver transplantation.

Alanine Transaminase↗

[Fibrous dysplasia of the maxillofacial bones. Clinical considerations].

OBJECTIVE: After a wide survey of the literature, the results of a clinical-statistic study carried out on twelve cases of maxillo-facial bones fibrous dysplasia, diagnosed and treated at the Oral and Maxillo-Facial Surgery Department of the II University of Naples, are reported. EXPERIMENTAL ASSAY: Retrospective study. MATERIALS AND METHODS: All the patients examined showed fibro-osseus lesions involving the mandible in eight cases, the maxilla in three cases and the frontal bone in one case. Seven patients were females and five males, aged between nine and seventy-two years. The surgical treatment was carried out on eleven patients: four cases were treated by complete surgical excision of the fibro-osseous lesions and seven cases by a conservative removal of the portion of the lesion contributing to the bone deformity. RESULTS AND CONCLUSIONS: All cases examined involved maxillo-facial skeleton structures as a sole localization, confirming that the polyostotic forms are more infrequent than the maxillary monostotic ones. The distribution of the cases according to age classes and lesion localization showed a higher incidence of fibrous dysplasia in the third decade of life and a clear predilection for the mandible. The observation of active lesions in old age shows that the disease may evolve also after the growth. The cases treated by radical excision of the lesions have not been followed from relapse; on the contrary three of the seven cases treated by conservative excision relapsed after a few years.

Adolescent↗

[Role of human papilloma virus in precancerous and cancerous lesions of the oral cavity. Review of the literature].

The authors review the literature on the role of human papilloma virus in premalignant and malignant oral tumours. They describe the biomolecular mechanisms of action and report the data of other authors regarding the incidence of the DNA of HPV in both normal mucosa of healthy subjects and in patients affected by disease, in tissues taken from benign and malignant lesions of the oral cavity. Having commented on these findings, they discuss the possible interference of analysis techniques, various kits and clinical conditions may have on the final results.

Female↗

Characterization of a protein recognizing minor groove binders-damaged DNA.

By using electromobility shift assay (EMSA), we have identified a protein able to recognize the DNA only if it was previously reacted with minor groove binders. This protein binds with very high affinity AT containing DNA treated with minor groove binders such as distamycin A, Hoechst 33258 and 33342, CC-1065 and ethidium bromide minor groove intercalator, but not with major groove binders such as quinacrine mustard, cisplatin or melphalan, or with topoisomerase I inhibitor camptothecin or topoisomerase II inhibitor doxorubicin. This protein was found to be present in different extracts of human, murine and hamster cells, with the human protein which appears to have a molecular weight slightly lower than that of the other species. This protein was found to be expressed both in cancer and normal tissues. By using molecular ultrafiltration techniques as well as southwestern analysis it was estimated that the apparent molecular weight is close to 100 kDa. We can exclude an identity between this protein and other proteins, with a similar molecular weight previously reported to be involved in DNA damage recognition/repair, such as topoisomerase I, mismatch repair activities such as the prokaryotic MutS protein and its human homologue hMSH2 or proteins of the nucleotide excision repair system such as ERCC1, -2, -3 and -4.

Animals↗

Liver transplantation for hepatocellular carcinoma: prognostic factors associated long-term survival.

Between December 1985 and February 1995, 260 orthotopic liver transplantations (OLTX) were performed on 238 patients at Niguarda Hospital. Sixty-three patients had hepatocellular carcinoma (HCC); in 13 of the patients HCC was incidental. All patients had negative lymph nodes. According to the Child classification, 13 patients were Child A, 30 Child B, and 18 Child C. According to the TNM classification, 11 patients were stage I, 22 stage II, 15 stage III, and 15 stage IVa. Pre-OLTX chemoembolization was performed on 25 patients. The perioperative mortality rate was 27% (17 patients). Overall survival and disease-free actuarial survival rates at 1, 3, and 5 years were 94%, 76%, 76%, and 83%, 75%, 75%, respectively. Survival curves were compared for 16 different variables. No difference was observed for all parameters analyzed except tumor site, TNM stage, pre-OLTX AFP levels and vascular infiltration. These results seem to demonstrate that the OLTX for unresectable HCC can be considered in specifically selected cases as the treatment of choice. An adequate tumor staging is also necessary for a better patient selection in order to increase survival.

Adult↗

Is the use of marginal donors justified in liver transplantation? Analysis of results and proposal of modern criteria.

A discrepancy exists worldwide between the number of suitable liver donors and the increasing demand for transplantation. Thus many centers have considered widening their liver donor acceptance criteria and this may increase the incidence of primary dysfunction (PD) with negative effect on the results of transplantation. In order to reduce the incidence of PD and improve patient and graft survival it becomes important to identify those risk factors associated with its occurrence. In a retrospective univariate and multivariate analysis we evaluated several donor, preservation and recipient parameters and their correlation with PD. In our Department 282 orthotopic liver transplantations (OLT) were performed on 256 adult patients over a 10-year period. Excluded were 15 cases with early vascular problems and 4 intraoperative deaths. A complete series of donor, recipient and procedure-related data were analyzed. About 30% of donors showed abnormal values. In 70 cases of PD (26%) there was a 61.4% graft failure rate compared with 15% in the group with immediate function (P < 0.05). Univariate analysis showed donor age, steatosis, ischemia time, amines, oliguria, hypotension and ICU stay to be significantly associated with PD. Multivariate analysis showed steatosis, ischemia time and amine dosage to be independent risk factors for the development of primary non function. In conclusion, the acceptance of marginal donors worsened the results of transplantation, but the rejection of these donors would reduce by about 30% our transplant activity resulting in increased mortality in the waiting list. Combinations of risk factors when possible should be avoided, and ischemia time, as the only variable that can be controlled, should be kept as short as possible.

Adolescent↗

[Aphthosis of the oral cavity: therapeutic prospectives].

After analysing of recurrent aphthous stomatitis the clinical and morphological aspects, the authors consider various therapeutic possibilities. They underline the relationship between therapy and clinical aspects of the pathology.

Adrenal Cortex Hormones↗

[The functional therapy of fractures of the mandibular condyle. Our experience].

This work dealt with clinical experience since 1992, in management by functional therapy of mandibular condyle fractures, of the Institute of Oral and Maxillo-Facial Surgery in the I Policlinico of Naples. In this work from 87 treated patients, only a group of 8 has been considered because it expresses the heterogeneity of all cases about the age, the sex, the kind and the level of fracture and the association with other fracture of the skull. The results obtained show that the functional therapy must be considered the first opinion in the mandibular condylar fractures at least there are specific conditions.

Adolescent↗

[The departmental concept in the therapy of facial dysmorphisms. A preliminary note on the psychological aspects].

The authors describe the work carried out with the intention of map and border in simple and repeatable way the risk of dissatisfaction in the patient candidates to cosmetic and oro-maxillo-facial surgery. It represent the first of a series of notes which propose to characterize patients with problems tied to the organization of the individuality in which, the discrepancy among expectations and obtained result, lead in the more serious cases, to a real crisis of identity or a depressed state of varied entity.

Craniofacial Abnormalities↗

[The malignant transformation of leukoplakia of the oral cavity. A review of the literature and clinical case reports].

After considering the leukoplakia as defined by the WHO, the authors examine the quantitative, qualitative, histopathologic and clinical aspects of leukoplastic lesions. Afterwards, the data concerning the incidence of the malignant evolution of leukoplakia are shown. Data that have been collected and shown during years of study and that are often discordant. For this reason a study on the literature since 1931 is carried out and all the possible causes that could have led to different results are mentioned. Than the authors, among 98 cases of leukoplakia, examine those that turned malignant. In five cases, after the first biopsy, the histopathological report found the presence of microcarcinoma while, in three other cases, in the follow-up, a malignant evolution was observed. This This study points out a percentage of malignant transformation of the leukoplakia equal to 2,94% in agreement with the study of Pindborg and Banoczy.

Aged↗

[The therapy of leukoplakia of the oral cavity. A review of the literature].

The authors examine the different therapeutic approaches that can be used to treat the leukoplakia of the oral cavity by examining the literature and doing a critical evaluation. Great importance is attached to methods like CO2 laser therapy, to the treatments with natural or synthetic retinoids, and at last, but not least traditional surgery. These seem to be the most efficient treatments. The data reported seem to confirm the role of surgery (traditional, laser) and the validity of pharmacological therapy with retinoids. On the other hand it is not possible to find long term follow up with bleomycin, selenium and beta interferon, even if at the beginning they seemed to be arouse lively interest.

Antineoplastic Agents↗

[Calcifying odontogenic cyst. A clinical case].

The calcifying odontogenic cyst (COC) is a rare lesion that involves the jaws which, at times, may evolve into a solid, benign, tumor-like mass. There is no significant sex predilection, but it is probably more common in later life. The diagnosis is base only on histologic examination that represents, in the best of cases, the only way to differentiate the COC from other pathologies. Such lesions include: odontogenic cyst, residual cyst, globulomaxillary cyst, lateral periodontal cyst, ameloblastoma (multicystic and unicystic), odontogenic mixoma, and still with calcifying odontogenic epithelial tumor (Pindborg tumor) and adenomatoid odontogenic tumor. The authors report a case of COC, starting point for a review of the clinical, radiographic and histomorphologic features of the lesion.

Calcinosis↗