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Biomedical subjects

G Liotta

Publications and source records attributed to G Liotta.

At least 37 records · Page 2Linked to original sources
PubMed1998

Comparison of four minimally invasive methods of laparoscopic vagotomy in a porcine model.

BACKGROUND: An experimental study in a porcine model was undertaken to evaluate the currently available techniques of laparoscopic vagotomy. METHODS: Four groups of pigs were studied. Under general anesthesia, the animals were submitted to either bilateral vagotomy, bilateral highly selective vagotomy, posterior truncal vagotomy with anterior highly selective vagotomy, or Taylor's procedure. Gastric acid secretion and intestinal motility were evaluated before and after the surgical procedure. The feasibility of the four different techniques was assessed by means of a personal difficulty score. RESULTS: All four procedures produced significant acid secretory reduction. Multivariate analysis showed that the factor most affecting the outcome was the difficulty score. CONCLUSIONS: Taylor's procedure was the easiest and safest technique. It also produced the best functional results for secretion and motility.

Animals↗
PubMed1998

[Learning curve for "tension-free" reparation of inguinal hernia].

A prospective randomized study of 106 patients with unilateral primary inguinal hernia who underwent "tension-free" mesh repair was carried out. Fifty-nine procedures (group A) were performed by a single experienced surgeon and 47 (group B) procedures were performed by a team of residents each with an experience level of less than ten cases. In group A the length of operation was statistically shorter; local anesthesia was more frequently used in group A, while intra-operative sedation and general anesthesia were more frequently used in group B. A subgroup of twenty patients (group C) operated on by residents with a personal experience of at least 5 tension free repairs was selected. No statistically significant difference in operation time and in anesthesia used were found between group A and group C. No significant difference was found between group A and group B in morbidity rate, mean postoperative stay, median time to return to work, and recurrence rate. Because easy, efficacy, and minimally invasive, the tension-free mesh repair remains the gold standard in the treatment of inguinal hernia.

Adult↗
PubMed1998

[Primary neuroendocrine carcinoma of the skin: clinical case].

A case of Merkel cell carcinoma of the skin is described. It is a rare primary skin tumor originating within the dermis with an aggressive biologic behavior. Clinical presentation of these tumors are not sufficiently distinctive to allow the preoperative diagnosis. Wide surgical excision with postoperative irradiation to the local site and regional lymphatics is recommended as the therapy of choice. Indications for chemotherapy are discussed and the guidelines for an appropriated follow-up are reported.

Aged↗
PubMed1997

[Laparoscopic cholecystectomy and respiratory function].

A prospective analysis of 58 patients undergoing laparoscopic cholecystectomy was undertaken to assess pulmonary function changes related to the surgical procedure. Pulmonary function tests were performed preoperatively, as well as 24 hrs., and 48 hrs. after operation. Additionally blood gas analysis was assessed 1 hr. and 6 hrs. after the procedure. At 24 hrs. from operation significant decreases in forced vital capacity, forced expiratory volume in 1", and Tidal volume to 72% (p < 0.001), 70% (p < 0.001), and 92% (p < 0.001) of preoperative values respectively were registered. There was a reduction in PaO2 (p < 0.001) and an increase in PaCO2 (p < 0.05) at 24 hrs. An increase in PaCO2 was also observed 1 hr. (p < 0.001) and 6 hrs. (p < 0.05) postoperatively. Blood gas analysis revealed pH value slightly lower than normal at 1 hr. from operation (p < 0.01). The pulmonary function tests returned to preoperative values at 48 hours.

Adult↗
PubMed1997

Familial and psychological risk factors of ulcerative colitis.

BACKGROUND: The aetiology of ulcerative colitis is still unknown. Several theories have been proposed taking into account psychological influences. AIMS: The present study was undertaken to test the hypothesis of a relationship between certain individual psychological patterns, stress, some familial variables, and ulcerative colitis. PATIENTS: A series of 122 patients with ulcerative colitis and a matched hospital control population were independently studied by a team of physicians and a team of psychologists. METHODS: State-Trait Anxiety Inventory (Form Y) and Sacks' sentence completion tests were submitted to all subjects in both populations. RESULTS: Data showed significantly higher anxiety trait and state in ulcerative colitis patients, whilst 84% of ulcerative colitis patients showed a variety of obsessional traits and an affectivity state characterized by introversion and emotional immaturity. A link was found with regard to relationship with mother, to the condition of single children in the male ulcerative colitis population (41% vs 18% controls), and to last born daughters in the female ulcerative colitis group (47.5% vs 27.9% controls). In addition, a previous stressful life event within the 12-month period prior to the investigation was found in 44.3% of ulcerative colitis patients and in 10.7% of controls. CONCLUSIONS: Psychological disturbances and familial condition are proposed as risk factors, if not actual aetiological variables of ulcerative colitis.

Adult↗
PubMed1997

Idiopathic recurrent pancreatitis successfully treated by hepatic vagotomy.

Idiopathic recurrent pancreatitis and sphincter of Oddi disorders have been increasingly found to be concomitant problems. Treatment of this condition requires disruption of the integrity of the sphincter of Oddi. The case of a 16-year-old girl with sphincter of Oddi motor disorders and idiopathic recurrent pancreatitis who was successfully treated with hepatic vagotomy. This result, if confirmed, could add to our present knowledge of the physiopathology and pathogenesis of sphincter of Oddi motor disorders.

Acute Disease↗
PubMed1996

Is there a causal connection between bile acids and colorectal cancer?

Bile acid composition was assessed in 50 patients with colorectal cancer as compared to that in a control group of 50 subjects. The two groups were age- and sex-matched. The overall bile acid values were similar in both groups, while the relative concentrations of primary and secondary bile acids were different, a significant increase in the patients with colorectal cancer being observed. This finding thus seems to confirm the existence of a link between colorectal cancer and cholelithiasis. Both conditions share common risk factors, such as alterations in cholesterol metabolism and bile acid composition.

Adult↗
PubMed1996

The long-term outcome of hepaticojejunostomy in the treatment of benign bile duct strictures.

OBJECTIVE: The authors review the treatment and outcome of patients with benign bile duct strictures who underwent biliary enteric repair. SUMMARY BACKGROUND DATA: The authors conducted a retrospective review of all clinical records of patients referred for treatment of benign bile duct strictures caused by surgery, trauma, or common bile duct lithiasis or choledochal cyst. The authors performed univariate and multivariate analyses of clinical and pathologic factors in relation to patient outcome and survivals. METHODS: Eighty-four patients with documented benign bile duct strictures underwent hepaticojejunostomy, choledochojejunostomy, and intrahepatic cholangiojejunostomy during a 15-year period (January 1975 to December 1989). Morbidity, mortality, and patient survival rates were measured. RESULTS: Early and late outcomes correlated neither with demographic and clinical features at presentation nor with etiologic or pathologic characteristics of the stricture. Best results correlated with high biliary enteric anastomoses and degree of common bile duct dilatation independently of bile duct stricture location. CONCLUSIONS: High biliary enteric anastomosis provides a safe, durable, and highly effective solution to the problem of benign strictures of the bile duct. Transanastomotic tube stenting is unnecessary. Endoscopic and percutaneous transhepatic dilatation seems more appropriate for the treatment of patients in poor condition and those with anastomotic strictures.

Adult↗
PubMed1996

[The role of identification of the recurrent laryngeal nerve in thyroid surgery].

Recurrent laryngeal nerve paralysis in the most serious complication of thyroid surgery. Five-hundred and sixty eight-consecutive operations for benign disease of the thyroid were retrospectively analyzed. Bilateral identification of the inferior laryngeal nerve was performed in 447 cases, whereas in 121 patients the identification was unilateral. The rate of primary postoperative vocal cord paralysis was 3.7% and permanent palsy rate was 0.8%. Present results compared with those of Literature confirm that recurrent nerve paralysis is a less frequent complication when the nerve is routinely identified and correctly prepared.

Female↗
PubMed1995

[Cholelithiasis and diabetes].

The occurrence rate of diabetes was analyzed in 3370 consecutive patients admitted and surgically treated for biliary lithiasis at the I Department of Surgery-University of Rome "La Sapienza"-between 1959 and 1993. The incidence of such association was found to be overlapping with that of normal population. The natural history and the outcome of patients surgically treated for biliary lithiasis do not seem to be burdened by a concurrent diabetes. Diabetes was in turn found to be correlated with a more frequent presence of stones in the biliary tract. Possible causes of this correlation are discussed. The need in these patients of a more accurate diagnostic approach and specific therapeutic solutions is stressed.

Adult↗
PubMed1995

[Mirizzi syndrome. Diagnostic and therapeutic considerations on 27 cases].

Mirizzi's syndrome is characterized by compression and/or stenosis of the common bile duct as a consequence of a stone impaction in the cystic duct or in the gallbladder neck. Clinical outcome, diagnostic pathway and operative management in 27 patients are presented. Ultrasound is referred as the first screening method, while E.R.C.P. and/or percutaneous transhepatic cholangiography allow to confirm the diagnosis. Surgical approach is considered to be of choice and technical expedients are suggested to prevent intraoperative damage and to repair defects of the common bile duct.

Adult↗
PubMed1994

Care requirements of people with ARC/AIDS in Rome: non-hospital services.

In Italy, care for people with AIDS (PWA) is centred on hospital services. However, other services are beginning to develop, both in the form of residential facilities and of home care. It seems, therefore, important to define the type of non-hospital services that should be supplied on the basis of AIDS patients' real needs. The aim of this paper is to contribute to the definition of care requirements by administration to 92 persons with ARC/AIDS of a questionnaire on Functional Multidimensional Evaluation to assess the demand for services in relation to the state of health and socio-economic situation of those interviewed. The pattern that emerged was one of severe socio-economic difficulties (most of the patients were drug addicts) and of major functional impairment (about 60% of those interviewed were not self-sufficient as far as Instrumental Activities of Daily Living were concerned). Among the main problems: difficulties of finding accommodation (almost 9% of those interviewed have no fixed abode) and economic difficulties; the demand for services was characterized by a lack of self-sufficiency. The most frequently required social services were help with preparation of meals, household chores and assistance with transport; the most frequently required health service was physiotherapy, which is also the least available. The study supplies useful information for the planning of non-hospital services in Italy and in other western countries with similar epidemiological situations.

AIDS-Related Complex↗
PubMed1993

[Cancer of the distal pancreas: comments on its diagnosis and therapy].

The authors report 14 cases of neoplasms involving the pancreatic body and tail. Duration and characteristics of symptoms at outbreak, diagnostic work-up, resection rates, morbidity and operative mortality are statistically analysed and compared with those found in the same period in patients with cancer of the pancreatic head. A number of important differences between these two locations are detected and analytically discussed.

Carcinoma↗
PubMed1993

[The impact of technology on the diagnosis and treatment of pancreatic carcinoma].

Between 1960 and 1989, 207 patients with cancer of the head of the pancreas were diagnosed in the 1st Surgical Department of the University of Rome "La Sapienza". While in the first period (1960-'74) diagnosis was performed on the basis of clinical signs and traditional radiological findings, imaging and endoscopy became progressively the main diagnostic tools in the second one (1975-'89). The authors analyse how the different diagnostic approach has influenced the therapeutical outcome. Earlier diagnosis, increased resectability, proper surgical indication, decreased morbidity and mortality, improvement of survival are the achieved results.

Carcinoma↗
PubMed1993

The impact of ultrasonography on the prognosis of pancreatic cancer.

The authors review 207 consecutive patients admitted for pancreatic cancer from 1960 to 1989 to the 1st Department of Surgery of the University of Rome "La Sapienza", in order to ascertain whether ultrasonography contributes to achieving the ideal goal of early diagnoses. The results achieved show a higher number of early diagnoses (< 1 month from first symptoms) performed by means of US, and a concurrent increase of cases amenable to radical surgery during the period 1975-1989, and basically from 1985 to 1989. Diagnostic imaging, namely US, is therefore deemed to provide earlier diagnoses and higher rates of pancreatic resectability.

Female↗
PubMed1984

[Clinico-statistical features of breast pathology in old age].

The authors, after discussing the incidence and etiopathogenesis of displastic and neoplastic diseases of breast in geriatric age, state their experience in the treatment of such illnesses. They emphasize the necessity for a treatment suitable for aged people, based on the selection of the patients, their preparation and the constant pre- and postoperative monitoring, and, as a conclusion, affirm the necessity for a strict interdisciplinary cooperation, pith the purpose to ecectively treat such pathology, showing a more and more increasing incidence in the population of the most advanced nations.

Aged↗
PubMed1983

[Immunologic profile of patients with carcinoma of the colorectum in the aged].

The authors, after explaining why they were persuaded to effect a study about the immunological outline of patients in geriatric age, suffering from colorectal carcinoma in different stages, state the methods they adopted for the in vivo and in vitro study of the cellular and humoral immunity. In order to better characterize these subjects, the authors also dosed tumoral markers, specific enough for the large intestine carcinoma, such as CEA and AFP. After reporting the results of their research, the authors, as a conclusion, assert there is certainly a straight correlation between immunity faults, bound to ageing, and neoplastic disease; therefore, the study of the immunological outline in aged patients is very useful, not only for prognostic purposes, but also to monitoring the immunitary state, mot inclined to meet depression in such patients as a consequence of the different therapies performed.

Age Factors↗