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Biomedical subjects

G Gravante

Publications and source records attributed to G Gravante.

70 records · Page 4Linked to original sources
PubMedDate not supplied

Atypical case of metastatic undifferentiated prostate carcinoma in a 36 years old man: clinical report and literature review.

Prostate carcinoma occurs infrequently in patient less than 50 years old with an incidence of 0.8% to 1.1%. In literature are described less than 20 cases occurred in younger men (< 40 years old). A 36 year-old man with a two-months history of lower back pain, anorexia and loss of weight, showed at clinical examination a mild enlargement of inguinal lymph nodes and right inferior leg and scrotus edema. CT scan demonstrated marked enlargement and fusion of pelvic, inguinal, sacral and periaortic nodes with a pelvic mass that caused local ureterohydronephrosis and obstruction of the urinary flow. X-rays showed osteoblastic metastases. At total body scintigram were observed fixation areas corresponding to lumbar metamers, pelvis, thigh bones, left humeral head, left acromioclavicular articulation and multiple ribs. Tumor markers resulted negative except prostate specific antigen (PSA: 500 mgr/ml) and prostatic acid phosphatase (PAP: 208 U/l); prostate biopsy showed an undifferentiated carcinoma. The patient was submitted to right percutaneous nephrostomy, chemotherapy (PEB, cisplatinum, etoposide and bleomycin for 6 cycles) and ormonotherapy (LHRH analogues) reporting a clinical partial response. After 6 months the disease progressed and was started a second line chemotherapy. After 18 months from diagnosis patient is still alive with progressing disease. Our patient represents, with respect to many features, an original clinical case of prostate carcinoma occurring in young age, for the atypical association of an undifferentiated carcinoma with high levels of PSA and PAP and with osteoblastic-pattern of bone metastases. Further studies would be useful to identify new risk factors for development of prostate cancer in young men in order to achieve early diagnosis.

Acid Phosphatase↗
PubMedDate not supplied

Symmetry of healthy adult feet: role of orthostatic footprint at computerized baropodometry and of digital formula.

Morphological aspects of orthostatic footprints (anterior heel, isthmus, posterior heel), using computerized baropodometry and of the digital formula were studied in 97 subjects (37 males, 60 females; median age: 20.9+/-1.56) at the Medical School of Palermo, Italy. The aim of this study was to contribute to our knowledge of the bilateral symmetry and asymmetry of the human feet in ethnically similar groups. We evaluated the length of the footprints (FL) and the widths of the anterior heel (AHW), isthmus (IW), and the posterior heel (PHW). Values were compared in the left and right feet of each subjects. The general morphology of the footprints was considered to determine bilateral correspondence or divergence. We also evaluated the digital formula to verify any bilateral correspondence. The linear measurements of the footprints did not show any particular bilateral conformity. The general morphology of the footprint showed bilateral correspondence in 76 subjects (78%): in 21 subjects (22%) it did not show any. Typological results of the bilateral orthostatic footprints showed normalfootprints in 54 subjects (55.5%): the isthmus included 1/3 to 2/3 of the AHW. Hollow footprints were found in 20 subjects (20.5%): the isthmus was less than 1/3 of the AHW. At clinical examination, using the digital formula, we found that Egyptian foot (1 degree > 2 degrees) was the most frequent (68%). The standard foot (1 degree = 2 degrees) and the Greek foot (1 degree < 2 degrees) were both present in 16% of the feet examined. Seventy-nine subjects (82%) presented bilaterally correspondent digital formulas: 1 degree > 2 degrees in 59 subjects (62%), 1 degree = 2 degrees in 9 subjects (9%), and 1 degree < 2 degrees in 11 (11%). While comparison of the bilateral linear measurements studied showed that there was primarily no bilateral correspondence, the morphological aspects of the footprints and of the digital formulas showed that bilateral correspondence was prevalent.

Adult↗
PubMedDate not supplied

Huge response to letrozole in inoperable T4 breast cancer: a case report.

A 73 years-old woman presented with locally advanced breast cancer (cT4b cN1 M0, stage IIIB) and atrial flutter. Because of the arrhythmia, chemotherapy or tamoxifen, although malignancy was hormone-sensitive, were discarded. Letrozole was started. Two months later, the breast nodule and skin ulceration cleared up. Surgery was performed. Nowadays, 24 months later, patient does fine, continuing letrozole as adjuvant treatment.

Aged↗
PubMedDate not supplied

A randomised trial comparing submucosal haemorrhoidectomy with radiofrequency bistoury vs. diathermic haemorrhoidectomy.

BACKGROUND: Haemorrhoid disease has become more and more frequent during the past years among western populations. Great attention has been paid in development of surgical procedures, in order to reduce post-operative pain (the main adverse effect of surgical treatment for haemorrhoids) and shorten execution time and hospital stay. This randomised clinical study compares the results obtained using submucosal haemorrhoidectomy with radiofrequency vs. diathermic haemorrhoidectomy. METHODS: Thirty-one patients were randomised to undergo submucosal haemorrhoidectomy with radiofrequency bistoury (16 patients, Group A) or diathermic haemorrhoidectomy (15 patients, Group B). The operating time, amount of pain and postoperative analgesic requirement, intra and post-operative complications and patient satisfaction were documented. RESULTS: The mean values for operative time have been 35.8 min for group A and 23.2 min for group B. According to pain score, patients' mean values for first day postoperative pain were 3.8 (A) and 5.8 (B). Pain at first evacuation 4.7 (A) and 6.5 (B). Pain at 7th postoperative day was 2.3 (A) and 3.7 (B). Patient's postoperative satisfaction rate was 6.0 (A) vs. 5.2 (B) at 3rd day and 6.7 (A) and 5.7 (B) at 6 months. CONCLUSIONS: In spite of relatively difficult execution and longer operating times, submucosal haemorrhoidectomy with radiofrequency bistoury appears to be the most precise and accurate treatment for IV degree haemorrhoids. Performing submucosal haemorrhoidectomy with radiofrequency bistoury allows us to reduce postoperative pain, bleeding and shorten hospital stay.

Adult↗
PubMedDate not supplied

Radiofrequency fistulectomy vs. diathermic fistulotomy for submucosal fistulas: a randomized trial.

BACKGROUND: Anal fistula represents one of the most frequent anorectal disease. Fistulotomy is considered the gold standard treatment but related problems are numerous (postoperative pain, bleeding, delayed or impaired wound healing). Fistulectomy lowers the recurrences but is less feasible with longer operating time and healing process. We applied the radiofrequencies to fistulectomy and compared the early and late results with those obtained from traditional fistulotomy. METHODS: Twenty patients were randomized to undergo radiofrequency fistulectomy (10 patients, Group A) or conventional fistulotomy (10 patients, Group B). We analysed the first postoperative day pain, intra- and postoperatory bleeding, operating time, complications (impaired or delayed wound healing, fecal incontinence) and any recurrences. RESULTS: The mean values for operative time have been 18.3 min for group A (range 15-26 min) and 17.9 min for group B (range 13-21 min). According to VAS scale, first postoperative day pain mean values were 2.8 for group A (range 2-4) and 4.1 for group B (range 3-5). Intra- and post-operative bleeding has always been negligible and faecal incontinence was never observed. Healing time mean values have been 3.5 weeks for group A (range 3-5) and 5.9 weeks for group B (range 4-8 weeks). Long-term results did not evidence complications or recurrences for both groups. CONCLUSIONS: The application of radiofrequencies to fistulectomy renders more feasible and easies the operation. Postoperative pain is smaller than traditional fistulotomy because of the lower temperatures used and for the shorter time spent in coagulating. This gives a faster wound healing. In conclusion we think that radiofrequency fistulectomy is technically more advantageous than traditional fistulotomy and furnishes better results.

Drug Administration Schedule↗
PubMedDate not supplied

A prospective randomized trial betwen subcutaneous lateral internal sphincterotomy with radiofrequency bistoury and conventional parks' operation in the treatment of anal fissures.

BACKGROUND: Anal fissure is a frequent proctologic disease. There are many and various treatments adopted to cure this disease. In this study we applied radiofrequencies to the subcutaneous lateral internal sphincterotomy and we compared the techniques in a randomised trial. METHODS: Patients have been randomized in two groups: in group A 18 patients underwent subcutaneous lateral internal sphincterotomy using radiofrequency bistoury while in group B 17 patients underwent the conventional lateral internal sphincterotomy described by Parks. RESULTS: The mean values for operative time were 6.6 min for group A and 9.1 min for group B. According to pain score, patients' mean values were 1.8 for group A and 1.9 for group B. Healing of the wound was faster in group A than group B, while healing of the anal fissure was approximately the same. CONCLUSION: Lateral subcutaneous sphincterotomy is the most advantageous operation for the treatment of the idiopathic anal fissure. The radiofrequency bistoury easies the procedure, lessens operating times and healing process of the surgical wounds.

Adult↗
PubMedDate not supplied

Physics of radiofrequency in proctology.

Radiosurgery is a new technique that utilizes an instrument, the radiofrequency bistoury, which is able to simultaneously cut and coagulate tissues with the emission of radiofrequencies. The first experiments about the utilization of radiofrequency currents on man were conducted between the end of the 19th century and the beginning of the 20th century. The first medical field of application was in oncology leading to the development of hyperthermia as an anticancer treatment. During the 80's the radiofrequencies have been introduced in cardiology to thermally ablate stable arrhythmic foci. Actually ear, nose, and throat surgery, dermatology, plastic surgery, vascular surgery, orthopaedics, neurosurgery and minimally invasive surgery use this new tool in their practice. The authors show the classification of radio fre quencies in the electromagnetic field, describe their historic development, their physics and their initial clinical applications by making a systematic review of the literature.

Animals↗
PubMedDate not supplied

Clinical applications of radiofrequency in proctology: a review.

The radiofrequency scalpel is an innovative instrument which allows to cut and coagulate tissues in an atraumatic manner, conversely to the electric scalpel. The authors describe the use of radiofrequencies in proctology by making a literature review for every major proctologic disease (hemorrhoids, anal fistulas, anal fissure, sinus pilonidalis, hypertrophied anal papillae). Many techniques have been developed with radiofrequencies in hemorrhoids treatment: coagulation, ablation with plication, Milligan Morgan and Parks hemorrhoidectomy. In the treatment of anal fissures, radiofrequency subcutaneous lateral internal sphincterotomy has been described. For anal fistulas, both radiofrequency fistulotomy and fistulectomy. Finally, radiofrequency sinotomy for sinus pilonidalis and coagulation for hypertrophied anal papillae are present in literature. The analysis of the results obtained with radiofrequency surgery compared with those of the "classic" surgery for proctologic disease shows that in most of them radiosurgery facilitates, accelerates and improves the surgical procedure.

Catheter Ablation↗
PubMedDate not supplied

Radiofrequency Y-V anoplasty in the treatment of anal stenosis.

BACKGROUND: Anal stenosis is a common proctologic disease often caused from hemorrhoids surgery. Treatments adopted are many and varied. In this study we applied radiofrequencies to the classic Y-V anoplasty operation and reported results obtained. METHODS: Eligibility criteria consisted of patients affected by anal stenosis. Exclusion criteria were those with contraindications to the surgical operation: pregnant patients or American Society of Anaesthesiologists Score III or IV. RESULTS: From January 2002 to December 2004 we operated 7 patients, 4 of them were males. Mean age at the time of diagnosis was 46 years. All patients referred obstructive defecation, painful evacuation or bleeding. Mean values for operative time were 30 min. Postoperative pain was 3.9 at day 1 and 3.0 at 7th day (VAS scale). Patient satisfaction rate was 6.6 at three weeks and 8.3 at 6 and 12 months. No recurrences were observed after 1 year. CONCLUSION: Radiofrequency Y-V anoplasty is a feasible and effective for the treatment of anal stenosis. The radiofrequency bistoury easies the procedure, lessens operating times and the healing process of surgical wounds.

Adult↗
PubMedDate not supplied

[Electrophysiologic relations in the lateral geniculate body].

Responses were evoked in the lateral geniculate body (L.G.B.) of "encéphale isolé" cats by single-shock stimulation of either the geniculate body or the optic tract of the other side. Responses to optic tract stimulation were modified following excitability changes in the contralateral L.G.B. due to topical application of strychnine and KCl. Laminar stimulation and recording in different layers (A, A1, and B) suggested the existence of a certain homotopic organization of L.G.B. interconnections. The activity evoked in the L.G.B. was found to be abolished by electrocoagulation of the posterior commissure and intermediate gray matter. These results point to the presence of a transthalamic pathway which might mediate L.G.B. activity to the contralateral visual cortex.

Animals↗