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Biomedical subjects

G Gandini

Publications and source records attributed to G Gandini.

At least 109 records · Page 6Linked to original sources
PubMed1990

Phosphatidic acid and not diacylglycerol generated by phospholipase D is functionally linked to the activation of the NADPH oxidase by FMLP in human neutrophils.

It is widely accepted that the activation of the NADPH oxidase of phagocytes is linked to the stimulation of protein kinase C by diacylglycerol formed by hydrolysis of phospholipids. The main source would be choline containing phospholipid via phospholipase D and phosphatidate phosphohydrolase. This paper presents a condition where the activation of the respiratory burst by FMLP correlates with the formation of phosphatidic acid, via phospholipase D, and not with that of diacylglycerol. In fact: 1) in neutrophils treated with propranolol, an inhibitor of phosphatidate phosphohydrolase, FMLP plus cytochalasin B induces a respiratory burst associated with a stimulation of phospholipase D, formation of phosphatidic acid and complete inhibition of that of diacylglycerol. 2) The respiratory burst by FMLP plus cytochalasin B lasts a few minutes and may be restimulated by propranolol which induces an accumulation of phosphatidic acid. 3) In neutrophils stimulated by FMLP in the absence of cytochalasin B propranolol causes an accumulation of phosphatidic acid and a marked enhancement of the respiratory burst without formation of diacylglycerol. 4) The inhibition of the formation of phosphatidic acid via phospholipase D by butanol inhibits the respiratory burst by FMLP.

Butanols↗
PubMed1990

Long-term follow-up of 'cured' prolactinoma patients after successful adenomectomy.

The long-term follow-up (greater than or equal to 4 years) of clinical, hormonal and radiological aspects in 22 'cured' prolactinoma patients after adenomectomy was studied. Dynamic secretion of PRL and TSH was also evaluated, in order to identify the persistence of any underlying abnormality of hypothalamic pituitary control and to predict relapses. A relapse into hyperprolactinaemia was shown in 36% of patients 5-90 months (mean 46) after surgery. This was accompanied by reappearance of clinical symptoms but not by the radiological demonstration of the adenoma in any patients. A significant PRL rise after domperidone, a dopaminergic antagonist drug, was shown in cured patients after surgery (mean +/- SEM peak, 2977 +/- 645 mU/l) but this was markedly lower than that observed in control subjects (5732 +/- 440 mU/l). In fact, normal PRL increments were shown in only 6/16 (37%) patients. TSH hyper-responsiveness to domperidone normalized in only 46% of patients. Similar PRL responses to those obtained with domperidone were shown when a TRH test was given. A relapse into hyperprolactinaemia was observed in six of ten (60%) non-responders to domperidone and in four of seven (57%) non-responders to TRH, whereas six normal responders to domperidone and TRH had not relapsed at that time. Plasma PRL levels during pregnancy showed increments lower than those observed in normal pregnant women only in domperidone and TRH non-responder patients. These results indicate that a relapse into hyperprolactinaemia and a blunted PRL rise during pregnancy were present only in patients with persistently reduced PRL response to dynamic tests.

Adenoma↗
PubMed1990

[Percutaneous transhepatic bilioplasty: long-term results].

We report the results of a long-term follow-up of 40/101 patients with benign biliary strictures treated with percutaneous balloon dilatation (PBD) at the Radiology Department of the University of Turin, from March 1983 to March 1990. We excluded all the patients who were not followed or treated after June 1988, being their follow-up shorter than 18 months. All patients underwent accurate clinical, biological (AST, ALT, gammaGT, alcaline phosphatase) and US controls. Mean follow-up was 33.5 months. Mean success rate was 75% in strictures of bilioenteric anastomosis, 86% in iatrogenic strictures of the common bile duct, 65% in sclerosing cholangitis, 80% in papillary strictures in which endoscopic treatment had not been possible for anatomical reasons. Our results, compared to the most important radiological and surgical series, show PBD to have lower morbidity than surgery and no mortality during the so-called peroperative period (30 days). Moreover, in case of recurrences, PBD can be repeated without further complications and does not affect eventual surgery.

Adult↗
PubMed1990

[Percutaneous transhepatic sphincterotomy].

The authors describe the technique employed for percutaneous transhepatic sphincterotomy as performed on 3 patients with common bile duct (CBD) stones. In all patients, previous endoscopic attempt had failed for anatomical reasons (Billroth II gastric resection or partial gastric resection with Brown anastomosis), and the ampulla could not be correctly incannulated with the sphincterotome. In all patients endoscopy was useful to check the position of the diathermic loop inserted percutaneously. Complete and immediate success was obtained in all 3 cases. No major complications occurred during transhepatic treatment. To date, 1 recurrence has been observed, and the patient has been retreated with bilioplasty. All patients were followed after 5-6 months with US, plain X-rays of the abdomen and blood tests (gamma Gt, alkaline phosphatase, and bilirubinemia). The authors suggest that percutaneous transhepatic sphincterotomy be employed electively in patients with biliary tree diseases in case the endoscopic approach failes.

Aged↗
PubMed1990

[The results of the percutaneous treatment of obstructed ureteral diversions. The technic and personal experience in 46 cases].

The ureteral diversions performed in the treatment of mainly malignant lesions of the pelvis with ureteral or bladder involvement may be complicated by strictures and cause hydronephrosis, pyelonephritis and lithiasis. Personal experience and technique are described as applied in the percutaneous antegrade drainage of different urinary diversions (cutaneous ureterostomy, ileal conduit, colon conduit, ureterosigmoidostomy, ureterocolostomy) in 46 patients. The good results obtained (70% success rate), the absence of major complications, the low cost and the little patient discomfort confirm the leading role of percutaneous treatment versus surgery in obstructed urinary diversions.

Aged↗
PubMed1989

Percutaneous treatment (including pseudocystogastrostomy) of 74 pancreatic pseudocysts.

Percutaneous treatment of 74 pancreatic pseudocysts was performed in 70 patients. Initially, single-step fine-needle aspiration was used and had a 71% (15 of 21 patients) recurrence rate. Better results were obtained with prolonged extragastric or transgastric external drainage, performed in 43 patients (46 pseudocysts). Two patients in this series (4.7%) required urgent surgery: one for gastric wall hematoma and the other for intracystic hemorrhage. Three patients (7.0%) were lost to follow-up. The recurrence rate in the remaining 38 patients (41 pseudocysts) was 23.7% (nine of 38 patients). Since 1986, seven patients have been treated with percutaneous pseudocystogastrostomy (one also underwent external drainage and is thus included in the previous series, too) after placement of a transgastric drainage catheter, with no recurrence (follow-up, 2-26 months). It is concluded that transgastric drainage should be performed whenever the anatomic situation is favorable and that a pseudocystogastric stent should be placed in these patients whenever secretions are still abundant after 7-10 days.

Drainage↗
PubMed1989

[Accuracy of CT in the demonstration of lymph node metastasis in pulmonary carcinoma].

The CT, surgical and histological findings were examined of 350 lymph nodes in a perspective study of 50 patients affected with lung cancer. CT accuracy could thus be evaluated in assessing the size of hilar and mediastinal lymph nodes; the incidence of histologically-proven metastases in nodes more/less than 10 cm in diameter could also be determined, together with CT diagnostic accuracy for nodal metastases. Finally, CT capabilities were also evaluated in distinguishing N0 from N1-N2 patients. CT proved to have high negative predictive value and low positive predictive value, which caused the authors to raise the normal threshold value of CT evaluation of the greatest diameter for hilo-mediastinal nodes from 10 to 20 mm.

Humans↗
PubMed1988

Percutaneous transhepatic cholangioscopy with a 2.8 mm fiberscope.

The authors describe their initial experience with a 2.8 mm (8.5F) fiberscope. The instrument, used to refine interventional radiology maneuvers of the intra- and extra-hepatic bile ducts, caused no additional discomfort to the 18 patients treated. The fiberscope permitted differentiation between different causes of biliary stenosis in the few cases where doubt persisted after percutaneous cholangiography. Brushing was also performed wherever necessary. The color, and thus the composition, of bile duct stones could also be determined. This has helped us to plan the therapy with methyl-tert-butyl-ether (MTBE) in patients with cholesterol stones. Compared with traditional fiberscopes (diameter of 5mm or more) the new instrument is easier to use, and allows more peripheral ducts to be reached, but is expensive and has a smaller field of view and fewer possibilities for therapeutic applications.

Bile Duct Diseases↗
PubMed1988

[Evaluation of the usefulness of ultrasonics in the diagnosis of cancerous cirrhosis. Comparison with CT].

Cirrhotic liver hepatocellular carcinoma (HCC) was evaluated with both US and CT. In a group of 600 cirrhotic patients 64 had HCC, which was confirmed at histology in 24 cases, and by disease evolution in the other 40; single focal degeneration was proven in 40 patients, multiple (2, 3 focal lesions), or diffuse degeneration (more than 3 focal lesions) in the remaining 24. Sixteen patients had associated portal thrombosis. US recognized 38/40 single HCC, 22/24 multiple or diffuse lesions, and 11/16 portal vein thromboses. Degeneration was most frequently hypo/isoechoic in small tumors, hyperechoic and mixed in large lesions. When small lesions are hyperechoic their differentiation from both hemangiomas and regeneration noduli is extremely difficult. In such cases CT is mandatory. US diagnostic accuracy is by far superior to that of CT: 95% vs 85% in single lesions and 91.6% vs 87.5% in diffuse forms. Overall accuracy is 93.7% for US and 85.9% for CT. The authors believe that US should be performed every 6 months on cirrhotic patients, so as to allow HCC to be detected in time for radical surgery, while CT should be performed only when doubts persist.

Adult↗
PubMed1988

[Percutaneous biopsy (PB) of solid thoraco-abdominal formations with instrumental guidance. The authors' experience].

The results are reported of 283 percutaneous biopsies performed on solid thoracic and abdominal masses. Indications to biopsy are examined at first, which are relatively limited in number if compared to other authors' opinion on the subject--i.e., when the tumor cannot be characterized with any other methodology, or in case of neoplasms whose histological type is to be known in order to plan therapy. The techniques employed are then evaluated, with a special emphasis on the needle caliber and the guidance method (US, radioscopy and CT). Correct samplings have been obtained in more than 90% of cases. Minor complications were observed in less than 10% of cases, while major complications were totally absent. In conclusion, percutaneous biopsy proves useful in those cases where exam indication is respected and an accurate selection is previously performed.

Abdomen↗
PubMed1988

[Use of an electrohydraulic lithotripter in the percutaneous treatment of biliary tract calculi. The preliminary clinical experience in 4 cases].

The results are reported of percutaneous transhepatic treatment with an electrohydraulic lithotripter in 4 cases of bile duct lithiasis. An electric discharge, generated by a bipolar electrode, gives origin to high-amplitude and low-frequency shock waves in the fluid medium which cause the stone to fragment. Complete resolution of lithiasis was obtained in 2 patients with intrahepatic calculosis. In the other 2 cases of massive lithiasis of intra and extrahepatic bile ducts the treatment, however incomplete, proved to be useful, as the biliary flux was rehabilitated and clinical symptoms disappeared. No relevant immediate side-effects were observed, except for well-tolerated pain during the discharges, and transitory hemobilia which solved spontaneously. No complications were observed in this series of patients. Electrohydraulic lithotripsy proves thus to be useful for supporting standard interventional radiology techniques in very complex cases of intra- and extrahepatic bile duct stones.

Aged↗
PubMed1988

[Use of a high-frequency pulsed hydro jet in the percutaneous treatment of biliary tract calculi].

A new system (Broxo Jet) is described for bile duct washing to complete mechanical maneuvers during nonsurgical treatment of intra- and extrahepatic calculi. The device is connected either to a percutaneous biliary drainage catheter or to a fibroscope, and provides a high-frequency pulsating water jet. Seven patients with intra- and extrahepatic bile duct stones were treated with this new technique. Complete resolution was observed in 4/7 cases. The water jet allows the mobilization of even the biggest stones and the elimination of stone debris, as well as the removing of fibrin and necrotic tissue fragments tightly attached to bile duct walls in subacute cholangitis.

Adult↗
PubMed1988

[Computerized tomographic evaluation of latero-cervical lymphatic metastasis of carcinoma of the larynx. Personal experience in 170 cases].

CT can be considered the most reliable technique in detecting nodal metastases of the cervical district. The Authors have studied 170 patients with laryngeal cancer (104 N0, 21 N1, 21 N2 and 24 N3 clinically) with CT of the cervical region during infusion of contrast material. All patients underwent radical neck dissection with pathological examination of the nodes. CT diagnosis and pathological findings were correlated. Our findings show that CT has an overall accuracy of 91.8% (100% in groups N2 and N3) and fed false positives and false negatives.

Adult↗
PubMed1988

[X-ray computed tomography in latero-cervical lymph nodes, clinically undetectable, in preoperative staging of malignant neoplasms of the larynx].

Postoperative CT of the latero-cervical lymph nodes was carried out in 25 patients suffering from laryngeal cancer. The surgically removed lymph nodes themselves were measured and examined histologically. 529/621 removed lymph nodes (about 85%) were recognisable with CT. The metastasized lymph nodes were clearly identified because of the presence of hypodense, poorly vascularised central foci. Some lymph nodes with a diameter of more than 15 mm on CT investigation proved free from metastatic lesions. This criterion should therefore be considered inadequate for diagnostic purposes. The CT cannot be held to be sufficiently precise to avoid conservative functional latero-cervical emptying as it is probably not able to recognise metastases without capsular rupture, not present in this series.

Adult↗