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Biomedical subjects

G Gandini

Publications and source records attributed to G Gandini.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Intrathoracic rupture of herniated stomach. Description of a case].

The authors describe a case of intrathoracic migration of the stomach consequent upon diaphragmatic laceration. Long after the traumatic event, intrathoracic stomach perforation occurred; it probably was due to stomach wall ischemia, as result of vascular compression. The lesion was diagnosed with conventional X-ray thoracic films and opacified stomach.

Adult↗
PubMed1993

Palliative treatment of extrahepatic bile ducts tumors.

Extrahepatic bile duct (EHBD) tumors often become symptomatic in an advanced stage when curative resection is seldom possible. In a group of 111 patients, 7 (6.3%) received no treatment, 32 (28.8%) underwent non-operative biliary drainage (NOD), and 72 (64.8%) underwent surgical exploration. Radical resection was possible in only 25 cases (34.7%); 14 patients (19.4%) underwent a biliary digestive bypass (BDB), 15 (20.8%) received a transtumoral biliary prosthesis (TBP), and 18 (25.0%) an external biliary drainage (EBD). Average survival rates were: 6.5 months after BDB, 4.0 months after TBP, and 2.8 months after EBD. In a second group of 2,066 patients with primary and secondary malignant obstruction of the upper EHBD, treated with the insertion of a Carey-Coons transhepatic transtumoral biliary prosthesis, the average survival was 4.3 months. The early morbidity rate was 0.6%. Obstruction of the prosthesis occurred in 91 patients (4.4%), and the late morbidity rate was 3.6%. Although EHBD tumor treatment results are generally poor, surgical exploration should be performed in all patients with acceptable surgical risk, and without evidence of disseminated disease. When resection of the tumor is not feasible, we favor the use of a BDB or of a biliary prosthesis over that of an external drainage. In poor risk cases or cases with evidence of disseminated disease, we prefer the placement of an internal prosthesis (PTBD or endoscopic.

Adult↗
PubMed1993

Differential effects of tyrosine kinase inhibition in CD69 antigen expression and lytic activity induced by rIL-2, rIL-12, and rIFN-alpha in human NK cells.

The effect of rIL-12 on induction of CD69 antigen expression and cytolytic activity in purified human NK cells was evaluated in comparison to the effects of rIL-2 and rIFN-alpha. It was found that rIL-12 directly induced CD69 antigen expression in NK cells, although the period of incubation required by rIL-12 was longer than the period required by rIL-2 or by rIFN-alpha. Similarly, the cytolytic activity induced by rIL-12 in NK cells against the NK-resistant target cell line Raji was consistently lower than the cytolytic activity induced by rIL-2 or rIFN-alpha when measured after 6 hr of incubation, and increased during the following 18 hr of incubation. To compare the involvement of tyrosin kinases in activation of NK cells induced by rIL-2, rIL-12, and rIFN-alpha, the effect of the specific inhibitor of tyrosin kinases, genistein, was evaluated on induction of CD69 antigen expression and lytic function mediated by the three cytokines. It was found that genistein inhibited CD69 antigen expression induced by rIL-2 and by rIL-12, but not that induced by rIFN-alpha. Unlike the effect on CD69 antigen expression, the cytolytic activity induced by all three cytokines was inhibited by genistein. These results, together with the finding that CD69 antigen expression induced by rIL-2 but not by rIL-12 or rIFN-alpha was inhibited by addition of rIL-4, strongly suggest that IL-2, IL-12, and IFN-alpha mediate their effects, leading to induction of CD69 antigen expression through different activation pathways.

Antigens, CD↗
PubMed1993

[Palliative treatment of esophageal neoplastic stenoses with self-expanding metallic stents].

Thirty Strecker nickel-titanium self-expanding metallic stents were implanted in 20 patients with esophageal strictures and inoperable neoplasms in the Departments of Radiology of the University School of Medicine of Ferrara, Genoa, Novara and Rome, from March 1992 to April 1993; follow-up ranged 1 to 13 months. Thanks to the stents, esophageal strictures could be dilated, significantly reducing dysphagia and allowing the patients to return on to a solid diet. Radiological and endoscopic exams proved the efficacy of the stents in all but 2 patients in whom the tumors had invaded the stent lumen and caused obstruction. In all cases the stents were highly biocompatible and well tolerated. Neither major complications, such as perforation or bleeding, were observed, nor minor ones, such as fever or migration from the site of implant, which may occur with plastic prostheses. To conclude, self-expanding metallic stents used in clinical trials for 13 months proved an effective method in the palliative treatment of malignant esophageal strictures.

Aged↗
PubMed1993

[Percutaneous transluminal renal angioplasty. Italian experience at 13 centers].

The data relative to 13 years' experience with percutaneous transluminal renal angioplasty (PTRA) in the 13 major interventional radiology centers in Italy were collected and analyzed to evaluate technical and clinical results. Our aim was to collect homogeneous results in a large series of patients, evaluating both the technical and the clinical success with a long-term follow-up (1 month-13 years). One thousand three hundred forty seven PTRA procedures (including 42 restenoses) in 1,073 patients were retrospectively reviewed. In 807 cases the cause of stenosis was atherosclerosis, in 442 cases fibromuscular dysplasia and in 24 cases arteritis in 12 cases, stenoses were present in patients that had undergone a surgical by-pass. Sixty-two stenoses in patients with solitary kidney and 102 in patients with renal failure were studied separately. The technical success (based on the morphology of the dilated tract) obtained in 91% of cases was considered, together with the clinical success (in 81% of cases), based on the decrease in blood pressure evaluated according to Martin's classification. The blood pressure values collected after the maneuver were also evaluated separately for the different types of stenosis etiology: atherosclerosis, fibromuscular dysplasia or arteritis; moreover, blood pressure was studied in solitary kidney patients and in those with renal failure. Complications were classified as major (4.2%) and minor (4.9%). The high success rate and the low incidence of complications we observed in our series suggest PTRA as the procedure of choice for high blood pressure patients with renal artery stenosis > 50% of the normal caliber.

Adolescent↗
PubMed1992

Increase of poly(ADP-ribose) polymerase mRNA levels during TPA-induced differentiation of human lymphocytes.

The non-mitogenic stimulation of human peripheral blood mononuclear cells (PBMC) with low concentrations of the phorbol ester 12-O-tetradecanoylphorbol 13-acetate (TPA) caused a progressive increase in the percent fraction of the cells that were positive for the early activating antigen CD69. At the same time, it caused a progressive increase in the steady-state levels of poly(ADP-ribose) polymerase (pADPRP) transcripts. A further increase in TPA concentration, while inducing the maximal expression of the levels of CD69 activating surface antigen, both in the presence or in the absence of proliferative activity, did not evoke any additional hightening of pADPRP mRNA levels. Time course of PBMC stimulation with a non-mitogenic dose of TPA showed an early increase in the accumulation of pADPRP mRNA, which changed at 8-16 h, and remained high for several days thereafter. On the basis of these data, we suggest that the increase in pADPRP mRNA may be associated with the commitment of human lymphocytes from a quiescent (G0) to an activated (G1) state.

Blotting, Northern↗
PubMed1992

Simultaneous assay for oxidative metabolism and adhesion of human neutrophils: evidence for correlations and dissociations of the two responses.

An assay method for the simultaneous evaluation of the oxidative metabolism and adherence of human neutrophils is described, together with certain specific applications. Incubations were performed in serum-coated microtiter plates, where oxidative metabolism was measured as O2- release and, after washing out the nonadherent cells, the adhesion was measured as activity of acid phosphatase. Three agonists tested in this system--opsonized zymosan, concanavalin A, and N-formyl-methionyl-leucyl-phenylalanine--induced both activation of O2- release and cell adhesion, but the two functions had time course and dose dependence patterns that varied depending on the stimulant. Particularly with concanavalin A, O2- release and adhesion response were markedly dissociated; this lectin at low doses increased neutrophil adherence without triggering any O2- production, whereas at high doses it increased both O2- production and adherence. Anti-integrin monoclonal antibodies did not affect adhesion induced by low-dose concanavalin A but inhibited the adhesion induced by the other tested agonists. Adhesion and O2- production were also found to be differentially affected by the NADPH oxidase inhibitor diphenylene iodonium, the sulfhydryl reagent N-ethylmaleimide and the A2 agonist adenosine, indicating that these neutrophil responses have various transductional pathways that also depend on the type of stimulus.

Adenosine↗
PubMed1992

Different sensitivity to interleukin 4 of interleukin 2- and interferon alpha-induced CD69 antigen expression in human resting NK cells and CD3+, CD4-, CD8- lymphocytes.

The effect of rIL-4 on CD69 antigen expression induced by rIL-2 or by rINF-alpha on human resting NK cells and CD3+, CD4-, CD8- T lymphocytes has been investigated. rIL-4 drastically inhibited CD69 antigen expression induced by rIL-2 in both cell types. In contrast, rIL-4 did not alter rINF-alpha-induced CD69 antigen expression. Consistent results were obtained evaluating the cytolytic activity of NK cells against the Raji target cell line: rINF-alpha-induced lytic activity was not inhibited by rIL-4, while rIL-2-induced lytic activity was drastically inhibited. Proliferative activity of NK cells induced by rIL-2, in contrast, was only slightly reduced by rIL-4. rIL-4 did not alter the expression of the beta chain of IL-2 receptor, evaluated in NK cells by indirect immunofluorescence. Expression of the alpha chain of IL-2 receptor could not be detected in NK cells by indirect immunofluorescence. It can therefore be suggested that the selective inhibitory effect of rIL-4 on rIL-2-induced activation of NK cells is not mediated by downregulation of alpha and beta chains of IL-2 receptor.

Antigens, CD↗
PubMed1992

Management of postoperative bile leakage with endoscopic sphincterotomy (EST) and a naso-biliary drain (NBD).

Between July 1987 and December 1990, 13 patients with postoperative bile leakage were treated with endoscopic sphincterotomy and a naso-biliary drain. All the leaks healed in two weeks, except for one (intrahepatic) that needed two months to heal in association with percutaneous management. The non-surgical treatment of bile leakage is the preferred approach on account of the superior safety, efficacy and cost-effectiveness as compared with surgical repair, which is associated with significant morbidity, mortality and costs. The treatment of choice has to be endoscopic, which is much easier and safer than the transhepatic approach, especially in the non-dilated duct, while another advantage over radiology includes the possibility for rapid definitive treatment of distal obstruction (e.g. residual stones). A leak from an extrahepatic duct heals rapidly, while a leak from an intrahepatic duct takes longer to heal and sometimes needs associated percutaneous drainage. Finally, the authors propose treating an extrahepatic bile leak merely with naso-biliary drainage without cutting the papilla, and an intrahepatic bile leak with endoscopic sphincterotomy, nasobiliary drainage and a bilio-duodenal endoprosthesis.

Bile Duct Diseases↗
PubMed1992

[The percutaneous treatment of the urological complications following kidney transplantation].

Renal transplantation is considered the treatment of choice in most cases of renal failure; the urologic complication rate ranges 1 to 10% in different surveys. This work was aimed at evaluating the application and results of interventional radiology in these cases. Since 1983, 24 patients (20 males and 4 females) whose age ranged from 18 to 63 years (mean age: 42 years) have been submitted to percutaneous maneuvers in our department. Thirty-four complications were treated: 14 stenoses, 11 fistulas, 7 urinomas and 2 transient obstructions. Complete success was obtained in 15/24 patients (62.5%), while 7/24 patients (29.16%) underwent reoperation and in 2/24 cases (8.34%) a definitive pyelostomy catheter was inserted. In 7 stenosis cases ureteroplasty was successfully performed and a double-J endoprosthesis inserted; the follow-up results (5-21 months) were satisfying in all cases. The only complication was one case of endoperitoneal hematoma. Considering the good results obtained, the low morbidity and mortality and the low cost, percutaneous maneuvers must be considered the treatment of choice in the urologic complications of renal transplants. When the percutaneous treatment of the main lesion fails, pyelostomy does nonetheless allow the drainage of urinary collections, the maintenance of renal function and the improvement of local and general conditions, which makes it easier to reoperate under elective conditions.

Adolescent↗
PubMed1992

[Tubal catheterization with selective salpingography in the diagnosis and therapy of fallopian tube obstruction].

Fallopian tube catheterization with selective ostial [correction of osteal] salpingography is a new technique for the diagnosis of tubal factors of infertility and also for the treatment of proximal tubal occlusion (PTO). In this study, 246 women were considered, 20-42 years old, with primary or secondary infertility, who presented a unilateral or bilateral PTO at hysterosalpingography (HSG). Catheterization and selective salpingography have been successful in 93.9% of the cases. Failures (5.6%) have been ascribed to obstructive organic diseases, where it was impossible to overcome the stenosis with the catheter or the guide-wire. Twenty-six spontaneous pregnancies were obtained (15 full-term deliveries) and 17 patients became pregnant after GIFT (13 full-term deliveries). At follow-up, after 12 months 4 of 10 patients had normal tubes, while 6 patients presented a new unilateral or bilateral PTO. No major complications occurred; nevertheless, ectopic pregnancy is a possible event, because of the mechanically re-established patency in a nonfunctioning tube.

Adult↗
PubMed1992

[Percutaneous treatment of bile duct lithiasis. Personal experience in the first 150 cases].

Since 1983 we have percutaneously treated 150 cases of bile duct lithiasis in which previous endoscopic maneuvers had been incomplete or unfeasible. Complete resolution of lithiasis was obtained in 139 of 150 patients. In 6 cases only partial success was obtained but symptoms subsided. In 2 cases the treatment failed and the patients underwent surgery. Minor complications were observed in 12.6% of patients and resolved either spontaneously or by percutaneous maneuvers. Mortality rate was 2%. After a follow-up period of 6-12 months, 9 patients had a recurrence, completely resolved with further percutaneous treatment. These cases never required surgery. We obtained the best results in patients with stones residual after cholecystectomy or a iatrogenic stricture of the biliary tree. We obtained good results in massive lithiasis with combined endoscopic, surgical and radiological procedures. Morbidity and mortality rates were lower than in surgical series and similar to the endoscopic ones. The short hospitalization, the low cost and the possibility of treatment on an outpatient basis should promote the spreading of percutaneous techniques in the treatment of bile duct lithiasis.

Adolescent↗
PubMed1991

Percutaneous transhepatic sphincterotomy--a report on 3 cases.

The technique of percutaneous transhepatic sphincterotomy is described. This procedure was employed in 3 patients with common bile duct (CBD) stones in whom a previous attempted endoscopic procedure had failed for anatomical reasons (a Billroth II gastric resection or a partial gastric resection with Braun anastomosis). Complete immediate success was obtained in all 3 patients. Furthermore, no major complications occurred during transhepatic treatment. The authors suggest that PTS be employed electively in patients with diseases of the biliary tree in whom the endoscopic approach fails.

Aged↗