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Biomedical subjects

G Favia

Publications and source records attributed to G Favia.

At least 109 records · Page 6Linked to original sources
PubMed1976

[Notes on the embryology and anatomy of the diaphragm].

The main steps in the embryogenesis of the diaphragm are summarised, with particular reference to details of major importance in the formation of congenital hernias. Morphogenetic abnormalities of the diaphragm are described. Malformations occurring during the different stages of embryonal development (agenesia, total or partial aplasia or eventratio, restructuring defects) and their incidence are also illustrated. A personal view concerning the topography of congenital hernias of the diaphragm is expressed, with particular reference to those proceeding through incostant foramina.

Diaphragm↗
PubMed1976

[Acute complications of hernias caused by congenital defects of the diaphragm].

Following a classification of the various types of congenital hernia of the diaphragm, the acute complications that may be caused by such defects of diaphragmatic morphogenesis are reviewed. Relative physiopathology is considered, particularly as regards the thoracic dimension of large hernias of the cupola. As regards visceral hernia, the most typical pictures of the two commonest complications, volvulus and strangulation, are described among other aspects. The clinical situation is outlined bearing in mind the diversity of anatomoclinical pictures in relation to the age of the patient, the type of hernia involved, and the period in which the observation was made. The surgical problems involved in acute complications concern the approach--although agreement is almost unanimous depending on the type of hernia--viscous reduction modalities and the type of plastic surgery which is required on each occasion. Postoperative complications and the prognosis for these hernias are reviewed briefly.

Diaphragm↗
PubMed1975

Postoperative chylothorax. Six cases in 2,500 operations, with a survey of the world literature.

We have systematically reviewed the literature concerning iatrogenic chylothorax and shall report our personal observations on the subject. Despite an increasing number of thoracic operations, injuries to the thoracic duct are infrequent. Cardiovascular and esophageal procedures are the most frequent causes of chylothorax. Malformations of the thoracic duct and other organs of the mediastinum have often been involved in lymphatic injury. Consequently, we believe that a complicating chylothorax may result from varied causes rather than solely from a surgical error.

Adolescent↗
PubMedDate not supplied

Role of bilateral adrenalectomy in Cushing's disease.

Of 206 patients with Cushing's syndrome observed from 1975 through 1991, 144 (69.9%) had pituitary-dependent Cushing's disease. Of the 110 patients who underwent pituitary surgery, 31 (28%) developed an early recurrence and 23 patients (20%) had a late relapse 1 to 5 years after primary pituitary exploration. We performed a one- or two-step total bilateral adrenalectomy in 43 patients-9 men and 34 (79.4%) women, with an average age of 47.5 years (range 13-58 years). Thirty-three of these patients had already been treated by previous transsphenoidal surgery or alternatively by external pituitary irradiation over a period of 1 to 10 years prior to adrenal surgery. Thirty-one patients underwent adrenalectomy by a double lumbar access or left lumbar and right subcostal incisions. In our series of 55 operations, perioperative complications included two splenectomies and two hemorrhages (7.3%). The early mortality rate was 3.6% (two patients). Minor complications consisted of wound infection (13.5%), bronchopneumonia or pneumothorax (four cases) with a 7- to 12-day longer hospital stay. Nelson syndrome occurred in 6 of 41 patients (14.6%). We therefore believe that bilateral adrenalectomy does play a major role in the treatment of patients with pituitary-dependent Cushing's disease unsuccessfully managed by transphenoidal surgery. It represents the definitive therapy for those patients in whom hypophysectomy was not able to provide satisfactory control of the disease.

Adolescent↗
PubMedDate not supplied

Adrenalectomy in primary aldosteronism: a long-term follow-up study in 52 patients.

From 1975 to 1989, 52 patients with primary aldosteronism underwent adrenalectomy. There were 16 men and 36 women. The average age was 42.5 years, ranging from 28 years to 70 years. They were all hypertensive, with average pre-operative diastolic pressures varying from 105 to 140 mm Hg (median 117 mm Hg). The subjective symptoms most frequently reported were headache (71%) and asthenia (53%). In all patients except two, serum potassium concentration was 3.3 mEq/L (median 2.7 mEq/L) at the time of diagnosis. Plasma aldosterone concentration was elevated in all patients, 48 +/- 5.3 ng/mL in the recumbent position and 52.6 +/- 6.0 ng/mL in the upright position. The operations carried out were 50 unilateral and 2 bilateral adrenalectomies. In 4 patients a transperitoneal approach was employed and in the remaining 48 patients an extraperitoneal flank incision was used. The histological findings were 47 adenomas (with dimension ranging from 1 to 4.5 cm), unilateral macronodular hyperplasia in 2 patients, an adenoma plus controlateral hyperplasia in 1 patient, bilateral hyperplasia in 1 patient, and unilateral hyperplasia in 1 patient. After long-term follow-up (median 77 months, range 13 to 189 months), 15 patients remained hypertensive (diastolic blood pressure up to 100 mm Hg). In 9 of these patients the hypertensive illness had been present for more than 5 years prior to operation. In the remaining 37 (71%) patients, the arterial pressure returned to normal and in almost half of the patients this result was evident one or two days after operation.

Adrenalectomy↗
PubMedDate not supplied

Expression of bcl-2 in oral squamous cell carcinoma: an immunohistochemical study of 90 cases with clinico-pathological correlations.

Apoptosis is a genetically determined process playing an active role in tissue size regulation, morphogenesis and removing damaged cells that could be potentially dangerous for their host. Several agents involved in apoptosis regulation, such as the bcl-2 family components, act as oncogenes and are involved in oral carcinogenesis. Aim of this study is to explore bcl-2 immunoreactivity in oral cancers and to assess its potential clinico-pathological implications. Ninety oral squamous cell carcinoma and 10 normal mucosal formalin-fixed, paraffin-embedded samples were analysed for bcl-2 expression by immunohistochemistry. Normal oral mucosa showed a cytoplasmic pattern of bcl-2 immunoreactivity in the basal cell layers. Seventy-four cases of carcinoma (83%) showed no immunoreactivity, at variance with 16 cases (17%) manifesting consistent cytoplasmic positivity. Overall, the peripheral cells of differentiating epithelial tumour islands were intensely stained, with decreasing immunoreactivity toward the centre of the neoplastic nests. Fully keratinised tumour cells showed inconspicuous or absent bcl-2 immunoreactivity. No statistically significant correlations could be demonstrated between bcl-2 immunoreactivity and the sex of the patients, tumour size and with the occurrence of lymph node metastases. Though a direct correlation was found between bcl-2 immunoreactivity and increasing tumour stage, this did not reach statistical significance. Furthermore, G1 and G3 tumours displayed higher percentages of bcl-2-positive cells in comparison with G2 neoplasms and the different distribution of bcl-2 immunoreactivity in G2 and G3 was statistically significant (p<0.05). Finally, patients with absent or low (scores 0 and 1) bcl-2 immunoreactive tumours manifested poorer overall survival rates in comparison with patients with moderate or high (scores 2 and 3) bcl-2 immunoreactive tumours but the difference was not statistically significant. In normal oral mucosa bcl-2 protein is selectively present in the basal cell layers and possibly participates in the control of the terminal keratinocytes differentiation. The study of bcl-2 immunoreactivity possibly may be useful for better characterising and predicting the prognosis of oral SCC but cooperative studies are needed to assess its applications in the clinical practice.

Aged↗
PubMedDate not supplied

[Primary hyperparathyroidism. Critical analysis of a 20-year experience].

PURPOSE: The aim of this study was to review our 20-year experience in the treatment of primary hyperparathyroidism (HPT) and to analyze clinical and biochemical findings in patients surgically treated in the nineties and before. MATERIAL AND METHODS: From 1978 to 1997, 302 patients with proved HPT underwent primary surgery. There were 95 (31.5%) males and 207 (68.5%) females with a median age of 53 years (range 11-82 years). Two groups of patients were considered: Group 1 (156 patients undergoing surgery between 1978 and 1989) and Group 2 (146 patients undergoing surgery from 1990 to 1997). RESULTS: No differences (p = NS) were found regarding age at operation and preoperative serum creatinine values. The most frequent symptoms in both groups were of rheumatological nature (54.5% and 42.5% in Groups 1 and 2 respectively). Renal stones were described in 60.3% and 42.5% of Group 1 and 2 patients, while peptic ulcerations or gastritis were present in 25.0% and 15.1%. No differences (p = NS) in the number of patients with neurological and neuropsychiatric rate and in the median size of the removed parathyroid glands were observed between the two groups. Asymptomatic HPT was more frequent (20.5% vs 7.7%) in patients who underwent parathyroidectomy from 1990. Average serum calcium preoperative levels and delayed diagnosis were greater (p < 0.01) in Group 1 (3.10 vs 2.90 mmol/L and 72 vs 24 months respectively). CONCLUSION: Increase of asymptomatic patients with HPT allowing an earlier surgical treatment may reduce the time of the of neck exploration and morbidity rate.

Adolescent↗
PubMedDate not supplied

Long-term follow-up study in breast cancer patients using serum tumor markers CEA and CA 15-3.

The aim of this study was to evaluate CEA and CA 15-3 changes in patients surgically treated for breast cancer. One hundred and three women (median age 59 years, range 31-83 years) with pT1-2, pN0-1, M0 breast cancer were followed up for at least 5 years. CEA and CA 15-3 serum levels were measured before operation and every 6 months during follow-up. The diagnostic sensitivity of CEA and CA 15-3 was 22.3% and 33.3% respectively. There was a significant difference (p < 0.01) between pre- and post-operative (6 months and 5 years after surgery) mean CEA serum levels independent of TNM staging. During follow-up, 21 (20.4%) patients showed recurrence of cancer and overall CEA and CA 15-3 sensitivity was 38.1% and 61.1%, with 98.8% and 91.2% specificity, respectively. Tumor marker measurement may be useful in post-surgical follow-up, but at present they are neither sensitive nor specific enough for early diagnosis of malignancy.

Adult↗