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Biomedical subjects

G Favia

Publications and source records attributed to G Favia.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Minimally invasive radioguided parathyroidectomy.

In the last years, with the aim of reducing operative time and having better cosmetic results, minimally-invasive parathyroidectomy (MIP) has become to be extensively performed. Several techniques are available, including video-endoscopic techniques, and radioguided parathyroidectomy. In patients undergoing radio-guided parathyroidectomy receive an intravenous injection of 99mTc-sestamibi 60-90 minutes before the operation was scheduled to start. Four early images are obtained 5 minutes after radiopharmaeutical administration, with the aim of confirming the side and site of the enlarged PT gland. Intraoperative nuclear mapping using a hand-held gamma probe and quantitative gamma camera counting in the four quadrants is obtained. A 2-3 cm incision is made, and the enlarged PT gland excision is guided by the probe, resulting in a decline in radioactivity in the corresponding quadrant. Intraoperative quick PTH is routinely assayed. When the PTH levels at 10 min fail to fall to less than 50% of the preoperative levels, a multiglandular disease should be suspected and a bilateral neck exploration is usually required. MIP is a safe, cost-effective alternative to bilateral exploration, and should be considered the procedure of choice in patients with primary HPT, when preoperative imaging tests have suggested the presence of a PT adenoma. Radioguided MIP may improve the success rate of surgery in patients with primary hyperparathyroidism.

Humans↗
PubMedDate not supplied

Medullary thyroid carcinoma: state of the art.

Medullary thyroid carcinoma (MTC) constitutes about 3-10% of all thyroid cancers. It arises from the parafollicular C cells that produce calcitonin (CT) and occurs as a sporadic form. or less commonly, as a hereditary form, as part of multiple endocrine neoplasia syndromes types 2A (MEN 2A) and 2B (MEN 2B). The hereditary forms are autosomal dominant traits associated with germline mutations of RET proto-oncogene. Progresses in genetics have permitted an improvement of management, screening and treatment. Surgery is the only successful treatment for MTC, as there is no effective adjuvant therapy for residual disease. A total thyroidectomy and vigilant management and surveillance of the neck are recommended. Interdisciplinary management including surgeons, endocrinologists, pathologists, radiotherapists, radiologists, and oncologists should be considered.

Adult↗
PubMedDate not supplied

The stenosis of the terminal esophagus after surgical repair of the hiatus hernia.

Eighty-two operations of hiatus hernia repair were performed at the General Surgery Department of the University of Padua from 1966 to 1975. Two cases of iatrogenic stenosis of the the terminal esophagus, whose correction required postoperative dilatations, occurred in this series. This complication should be separated from the transient dysphagia frequent occurring, without radiologia or endoscopic evidence of esophageal lesions, after hiatus hernia repair. The stenosis followed two different repair techniques but, at present time, it is impossible to establish a relationship between occurrence of the iatrogenic lesion and repair techniques used. Eventhough iatrogenic stenosis of the terminal esophagus does not occur frequently, it is a possible complication to keep in mind while performing hiatus hernia repair, because it is exclusively related to defects of the surgical technique.

Adolescent↗
PubMedDate not supplied

[Lipolytic and lipoprotein lipase activity of subcutaneous and visceral adipose tissue in Cushing's syndrome].

Cushing's syndrome has been recently compared to visceral-type obesity, since it is characterised by the accumulation of adipose tissue at a deep abdominal site, to the detriment of the subcutaneous adipose panniculus, and is associated with insulin-resistance and hyperlipemia. The aim of the present study was to evaluate the influence of glucocorticoid hormones on lipolytic activity (index of FFA mobilisation) and on lipoproteinlipase (LPL) activity (an index of the accumulation of triglycerides) in subcutaneous and perirenal adipose tissue in order to clarify the mechanisms involved in this type of accumulation in Cushing's syndrome. Five patients (4 F and 1 M) were included in the study, mean age 27.8 +/- 3.7 years and BMI 21.3 +/- 1.2 kg/m2; patients were hospitalised in the 2nd Surgical Clinic at the University of Padua and underwent surgery for secondary corticosurrenal hyperplasia with ACTH secreting hypophysial adenoma. Lipolytic activity in subcutaneous adipose tissue in these patients was significantly lower (p less than 0.05) than in control subjects, in particular after noradrenalin stimulation (p less than 0.01). No significant difference was observed when lipolytic activity in subcutaneous adipose tissue was compared to that one in perirenal tissue. LPL activity in subcutaneous adipose tissue did not reveal statistically significant differences compared to control subjects, although values were lower. A further decrease in LPL activity, which was not however significant, was observed in perirenal tissue in comparison to subcutaneous tissues in the same patients. The mean weight of adipocytes (ug) was slightly lower in subcutaneous adipose tissue compared to control subjects and even lower in perineal tissue in comparison to the subcutis in the same patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMedDate not supplied

Inflammatory stenosis of the trachea.

The authors report their experience of 30 cases of inflammatory tracheal stenosis. Of the patients, 53.4% showed postoperative improvement, while in 10% mediocre results were observed (50% reduction of the tracheal lumen). After a second operation, however, the rate of failure was reduced from 26.6% to 13.3%. Postoperative mortality was 10%. An examination of these results demonstrates that tracheal surgery is not always successful at the first attempt and that the complications involved (granulations, recurrent stenosis) require further definition.

Humans↗
PubMedDate not supplied

Lymphoepithelial cysts of salivary glands in HIV-infected patients: clinico-pathological and immunohistochemical features.

The parotidectomy specimens of 3 HIV-infected patients with lymphoepithelial cysts (CLL) have been used to study, with an immunohistochemical method, the expression of the following antigens in histopathological sections: Cytokeratins, CD3, CD20, CD35, CD68, MAC387, Kappa and Lambda light chains. The purpose of the study was to ascertain if CLL of salivary glands parallel the immunophenotype of extrasalivary systemic lymphadenopathy (LAS). The results of this study show that the epithelial lining of CLL does not derive from preexisting ducts and that the immunophenotype of CLL very closely resembles that of LAS. These features seem to suggest that CLL and LAS are tightly related diseases and that probably surgery is not the elective treatment for this lesion.

Adult↗
PubMedDate not supplied

Langerhans cells in periimplantar gingival tissues: an immunohistochemical study of 14 cases.

The presence and the immunophenotype of Langerhans cells (LC) have been investigated in formalin-fixed, paraffin-embedded biopsies obtained from 14 patients with dental titanium implants in which periimplantar tissues had been removed after different intervals from implant positioning. For the phenotypic characterization of LC and other immunocompetent cells in periimplantar tissues the following antigens have been investigated: CD3, CD20, CD35, CD68, MAC387, S-100 Protein and HLA-DR. The immunohistochemical APAAP method has been employed for antigen detection. The study has revealed that rare LC are detectable in the basal epithelium and in the lamina propria of periimplantar tissues removed after 2 months from implant positioning. In these specimens, LC only showed S-100 Protein reactivity; the mild inflammation which was present in the lamina propria was mainly sustained by B-lymphocytes. In samples from patients with dental implant positioned more than a year before, a higher number of LC was detected; the LC were scattered throughout the epithelium and were also in close contact with abundant T-lymphocytes and macrophages in the lamina propria. In patients with long-standing implants, LC appeared immunoreactive to S-100 Protein and HLA-DR. The results of this study show that LC are present in epithelial and mesenchymal periimplantar soft tissues and that their number seems to increase with the duration of implants. The variation in number and in the phenotype of LC may suggest that LC play a relevant role in the immune interactions between host and dental implants which might be important in the complex mechanisms of integration of implants within bone.

Antigens, CD↗
PubMedDate not supplied

[Surgical approach in the treatment of recurrent primary hyperparathyroidism].

Recurrent or persistent primary hyperparathyroidism (HPT) is a rare occurrence requiring generally a careful reoperation. From 1980 to 1992 a total of 192 patients underwent bilateral cervical exploration following a diagnosis of primary hyperparathyroidism. Persistent of recurrent HPT was found in 6 (3.04%) of our cases. In two patients a subtotal parathyroidectomy was performed (parathyroid hyperplasia) and hyperfunctioning parathyroid tissue was found at neck exploration. In one case an ectopic adenomatous fifth gland was found in mediastinum at reoperation. Three patients with recurrent HPT had a parathyroid carcinoma but in only two cases it was possible to identify and remove the pathologic tissue preoperatively localised in mediastinum by double-tracer scintigraphy and CT scan 6 and 15 months after first operation respectively. The third patient with parathyroid carcinoma was inoperable on account of multiple metastases both cervical and thoracic.

Follow-Up Studies↗
PubMedDate not supplied

Expression of phosphotyrosine in squamous cell carcinoma of the oral mucosa. Preliminary study.

Phosphotyrosine (pTyr) is the product of activation of Epidermal Growth Factor receptor (EGFr) in normal and neoplastic oral keratinocytes. As previous studies revealed that EGFr expression may vary with differentiation in several squamous cell carcinomas (SCC), we investigated the expression of pTyr in 30 cases of oral SCC in which EGFr-immunoreactivity had been previously studied. This study was carried out with monoclonal antibodies using an immunohistochemical APAAP method on formalin-fixed, paraffin-embedded samples. The results of this study show that pTyr is expressed in all cases of oral SCC and that its expression is not correlated with tumor differentiation. The Authors suggest that the mechanism of EGFr-mediated cell differentiation and mitosis might short-circuit EGFr in some instances and lead to the phosphorilation of Tyrosine, probably following the stimulation by other factors. This hypothesis needs to be confirmed by appropriate studies on the dynamic biology of oral squamous cells.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Presence of neuroreceptors in normal and diseased temporo-mandibular joints.

An immunohistochemical study was performed on the articular disk and periarticular tissues of the temporo-mandibular joint (TMJ) in order to ascertain the presence of neuroreceptors (NRec) in these sites. The study was carried out with the APAAP technique on tissue samples obtained from 10 subjects without known TMJ disease and from 5 patients with severe TMJ arthritis or arthrosis. The antibodies used were directed against the following antigens: Gliofibrillary Acidic Protein (GFAP), Leu-7, Myelin Basic Protein (MBP), Neurofilaments 68 kD (NF), Neuron Specific Enolase (NSE), S-100 protein (S-100) and Synaptophysin (SYN). This study revealed that Ruffini's-like, Pacini's-like and Golgi's-like receptors can be demonstrated in TMJ periarticular tissues and that free nervous endings are present in the subsynovial but not within the articular disk. In the latter, elongated cytoplasmic processes of chondrocytes demonstrated strong S-100 immunoreactivity but they were unreactive with all other antibodies. These cytoplasmic processes were more abundant and thicker in the samples obtained from patients with diseased TMJ. The results of this study confirm that different NRec are detectable in TMJ periarticular tissues but they are absent within the articular disk. In the latter site, only chondrocytic processes are evident, especially in diseased TMJ, and they might have been confused with nervous endings in previous morphological studies. Nevertheless the absence of immunoreactivity for NF, NSE and SYN proves that they are not of neural origin.

Cartilage↗
PubMedDate not supplied

[Adenolymphoma of the salivary glands. The anatomicoclinical, epidemiological and therapeutic aspects of 76 cases].

A series of 76 cases of adenolymphoma (Warthin's tumor) of the salivary glands is presented with emphasis on its epidemiological, clinico-pathological and therapeutic features; together with the analysis of the clinical records and of the epidemiological data, this study has reevaluated the histopathological features of the 76 cases of Warthin's tumor on hematoxylin-eosin stained slides. On these bases, the authors underline the frequent multifocality and/or bilaterality of Warthin's tumor (11.3% of cases), its frequent association with tumors of other sites (11.3% of cases), the prevalence in males (M:F ratio = 24:1) and in adults (mean age: 57 years) of this type of tumor. Furthermore, this study confirms the parotid gland as the elective site for Warthin's tumor and the possibility to categorize this entity into four different histological types. The latter finding should be kept in mind especially when fine needle aspiration (FNA) is used as a preoperative diagnostic procedure for Warthin's tumor to avoid misleading diagnosis and overtreatment. From the analysis of the results the authors underline the need for a complex and multidisciplinary approach to the diagnosis of Warthin's tumor in order to allow conservative surgery with preservation of the facial nerve.

Adenolymphoma↗
PubMedDate not supplied

[Intestinal occlusion caused by cecal carcinoid].

It is possible that carcinoids present themselves by a surgical emergency, without a < >. For these reasons, whenever a rational treatment is requested, an intraoperative diagnosis should be performed. In fact these neoplasms--owing to a less intense aggressiveness--present more indications to undergo surgery. In fact the authors report a case of caecum carcinoid characterized by the lack of typical symptoms of the homonymous syndrome. Urgent surgery was performed because of intestinal occlusion; the ileocaecal valve involvement caused the necessity of a large ileocolic resection with a L-L ileo-transverse anastomosis. The diagnosis of carcinoid was revealed only by the definitive histopathological examination.

Carcinoid Tumor↗