Biomedical subjects
Publications and source records attributed to G Maggi.
Three recently observed cases of Castleman's tumour are described. A brief summary of the clinical histories, themselves of little significance, the histological, diagnostic and therapeutic aspects of the disease are examined. The series is shown to be fully in line with those reported in the literature, and support is given to the view that the tumour is of inflammatory origin.
A case of solitary plasmacytoma of the lung is presented. The patient is still alive three years after surgery. The anatomical and clinical features of this rare form are discussed. Stress is laid on the fact that diagnostic certainty can only be obtained immunopathologically. It is also recommended that patients be subjected to radiological and laboratory examination in the postoperative period, and every six months for several years, to detect the possible occurrence of multiple myeloma.
Collapse of liver parenchyma, as seen in acute hepatitis with bridging necrosis, can be distinguished from new fibre formation in chronic liver disease by orcein staining. This shows abundant elastic fibres in association with fibrosis, but not in areas of collapse.
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In every serious thoracic or abdominal injury, or both, a hernia of the diaphragm should be suspected and always sought clinically and roentgenologically. If a hernia is present, compatible with the condition of the patient, it should be operated upon immediately. The choice of surgical access depends upon the associated lesions. We prefer thoracotomy as the surgical approach if important submesocolic lesions are not present. In instances of a late diagnosis, the approach should always be through the chest. The late results, in patients diagnosed and operated upon early, are good and are comparable with those obtained in operations of the thorax for nonneoplastic conditions. The surgical approach of choice for the treatment of such hernias is a thoracotomy both in the early as well as in the late stages, provided that no important submesocolic lesions are present.
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In spite of improvements in diagnosis and treatment, the fatal prognosis of lung cancer has persisted over the course of 25 years in a series of nearly 4000 patients. Only 30% (1149 cases) were operable, and on 23% of those resected (i.e. 7% of the total) survived for 5 years. An assessment is made of the relationship between survival and sex, age, tumour size and site, radiological picture, stage of invasiveness, type of surgery and degree of radicality, histological picture, and number of circulating lymphocytes. Age, sex and the type of resection (lobectomy or pneumonectomy) had no relation to prognosis. Palliative surgery was always associated with a fatal prognosis, as were cases with invasion of the chest wall, or, more particularly, with oat cell cancers. The outlook was more favourable in cases where radical treatment was given, in cases of squamous cancer, as opposed to other histological types, in those in stage 1 (Am. Joint Committee classification), and those with greater than 2000/mm3 lymphocytes--especially in adenocarcinomas.
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Review of 52 cases of thymoma (41 typical, 11 atypical) studied radiologically and controlled surgically and anatomo-pathologically. Differential diagnosis is discussed; the importance of pneumomediastinum and angiography is stressed and a number of cases are reported in detail.
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A case of neurinoma of the vagus nerve localized in the cervical, intertracheo-oesophageal region is described. After a survey of the literature on the subject, the differential diagnosis and operative technique are discussed.
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After a diffuse introductory discussion on S-adenosylmethionine methyltransferase activity, the results of an experimental trial carried out on 70 hospitalized patients with chronic hepatitis either persistent or aggressive, and with hepatic cirrhosis at various degrees, are reported. A first group of patients was treated with SAMe (S-adenosylmethionine) intravenously administered for 20 days at two daily doses of 15 mg. The second group was instead-receiving, still by i.v. route, 20 mg of fructose-1-6-diphosphage sodium salt, as a drug for comparison given twice a day at the doses of 2.5 over a 20 days' period. The protidemia picture and in particular the albuminic fraction, generally altered in all the cases under study, have been rapidly and significantly restored only in the group of patients treated with SAMe this indicating the efficacy of this molecule on the liver function.
An analysis is made of the results obtained in 50 papilliferous and 39 follicular thyroid tumours operated between 1949 and 1969, and forming part of a series of 150 thyroid cancer cases. If not radically managed, papilliferous tumours recur in the neck lymph nodes, though successful reoperation and survival for many years are possible. Follicular forms however, recur in the gland itself in 50% of cases, and prove fatal in one case out of three, even if reoperated. If the first operation is radical, the results are excellent when the tumour is contained in the thyroid, and will be good even when there are already metastases in the neck nodes. Recurrences in this site can be successfully reoperated and a cure obtained. Results will be poor, however, when invasion of the neck itself has begun.