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Biomedical subjects

G Nuzzo

Publications and source records attributed to G Nuzzo.

At least 55 records · Page 3Linked to original sources
PubMed1983

Rupture of multiple hepatic adenoma and oral contraceptive use: a case report.

A 38-year-old woman was seen with a hemoperitoneum caused by rupture of a hepatic adenoma of the right lobe. The patient had been taking oral contraceptives for ten years, but discontinued their use three years previously. During the postoperative course a second adenoma of the contralateral lobe, not diagnosed at the first operation, ruptured. The relationship between oral contraceptive use and hepatic cell adenoma is briefly reviewed.

Adenoma↗
PubMed1983

[Pharmacological test with cerulein during manometric cholangiography via external biliary drainage].

The manometric post-operative cholangiography through external drainage is now a method of everyday use. However in some cases the substenotic appearance of the terminal bile tract and of the Oddi's sphincter gives rise to doubts as to the real cause of this alteration. Caerulein solves the functional hypertone. It also starts a good peristalsis of the terminal bile tract, reducing the intrabiliary pressure and causing an evident transpapillary passage. Thus, the use of this substance allows a differential diagnosis between organic or functional stenosis.

Ceruletide↗
PubMed1982

Giant aneurysm of the pericallosal artery. Case report.

A case is reported of a thrombosed giant aneurysm of the pericallosal artery. Neurological presentation was attributable to the acute swelling of the aneurysmal mass after rapid and massive intraluminal thrombosis. This case demonstrates that initial symptoms in giant aneurysms may be related to the thrombotic events within the enlarged sac. The computerized tomography characteristics of this case are reported and discussed.

Adult↗
PubMed1978

CT and arteriography in cerebral ischemia. A preliminary note.

Sixty patients with cerebral ischemia were studied by both CT and angiography. The results are: 1. Thrombosis of the internal carotid artery: CT shows a hypodensity lateral to the frontal horn. 2. Thrombosis of the middle cerebral artery: the hypodensity occupies the convexity of the frontal, parietal, and temporal lobes. 3. In thrombosis of the posterior cerebral artery there is an occipital hypodensity, while in thrombosis of the vertebral artery the hypodensity occupies a cerebellar hemisphere. 4. Circulatory disturbances without occlusion of the major cerebral vessels: there is a disproportion between the serious CT lesion and paucity of the angiographic findings.

Adolescent↗
PubMed1977

Computerized tomography and encephalography.

This preliminary paper compares encephalography and computed tomography as regards the duration of the examinations, the technical difficulties and their diagnostic values. Some examples are reported to demonstrate the complementary importance of the two techniques.

Brain↗
PubMedDate not supplied

[The surgical risk of laparoscopic cholecystectomy].

Laparoscopic cholecystectomy has become the treatment of choice for gallbladder stones. As a matter of fact, the advantages related to the significant reduction of postoperative pain and the early mobilization of the patient, with a decrease of general surgical risk, have been well demonstrated. Also the complications of the surgical wound have been drastically reduced. On the contrary, iatrogenic trocar-related injuries represent specific complications of laparoscopic technique. However, the incidence of these complications, mostly the more severe ones, may be significantly reduced with routine use of the "open" technique. The increased incidence of common bile duct (CBD) injuries in laparoscopic cholecystectomy compared with the conventional technique may be partly explained with the learning curve related to the rapid diffusion of this new approach. An appropriate training, a meticulous operative technique and an early conversion to open procedure in case of intraoperative difficulties may reduce the risk of a CBD injury. In this work the authors' experience of 400 laparoscopic cholecystectomies without CBD injury and major complications is presented. Conversion rate was 5.2% in patients with simple symptomatic cholelithiasis and 37.5% in patients with acute or subacute cholecystitis.

Adolescent↗
PubMedDate not supplied

[Intrahepatic calculosis].

A review of one-hundred cases of intra-hepatic lithiasis, observed between 1967 and 1996 by the same surgical team, was reported in this paper. There were 61 cases of migrated stones and 39 cases of primary duct stones (31 above a stenosis and 8 associated to biliary malformations). 83 patients underwent surgery: in 31 cases, gallstones were removed through the CBD, while a bilio-enteric anastomosis was required in 47 cases; 5 patients underwent a left liver resection. Finally, 17 patients were treated by non-surgical means (endoscopic or radiologic). In a first period, diagnosis was made intraoperatively by cholangiography or choledochoscopy and surgery was the only therapeutic option. After 1980, diagnostic procedure included ultrasonography, CT and direct cholangiography (endoscopic or percutaneous). Consequently to the development of endoscopic (ERCP) or percutaneous (PTC) approaches to remove intrahepatic gallstones, many patients were treated by these non-surgical means, which, in some cases, were associated with extracorporeal lithotripsy. Abnormalities of intrahepatic biliary tree represented an elective indication for liver resection in the last years. The clinical results improved progressively: mortality was 8.3% in the first ten years (67-76), 7.1% in the second decade (77-86) and there was no mortality in the last ten years. In the first decade, intrahepatic biliary tree was completely cleared from gallstones in the 70.8% of cases, in the second decade in the 80.9% of cases and, in the last ten years, in the 97% of cases.

Adult↗
PubMedDate not supplied

[Surgical resection of pancreatic cancer].

AIMS AND BACKGROUND: Surgical resection offers the only potential cure for pancreatic carcinoma. Although the overall prognosis remains a dismal, several recent series have reported an encouraging increase in 5-year survival after resection, exceeding 20%. As the reasons for this improvement are not clearly understood, numerous clinico-pathological parameters (demographic, intraoperative and histopathologic factors) have been investigated to evaluate their role in predicting long term survival. In this single-institution study, immediate and long-term outcome after pancreatic resection in patients with pancreatic adenocarcinoma was retrospectively evaluated, focusing attention on the possible impact of different clinico-pathologic factors on long-term survival. METHODS: Sixty-six patients with a confirmed histologic diagnosis of adenocarcinoma of the pancreas, treated by pancreatic resection at the Department of Surgery of the Catholic University of Rome in the years 1988-1997, were retrospectively analyzed. Morbidity and survival data were reviewed and potential prognostic factors were compared statistically by univariate analysis. RESULTS: There was no postoperative mortality. Twenty-five patients (38%) developed major operative complications. Pancreatic fistula was the most common complication, and occurred in 7 patients (11%). The actuarial overall and disease-specific survival for all 66 patients were respectively 58% and 59% at 1 year, 27% and 31% at 3 years, and 13% and 20% at 5 years, with a median survival time of 13.4 months. Nodal status was the only single factor significantly affecting survival by univariate analysis. The 3-and 5-year survival rates were respectively 35% and 19% for node-negative patients and 7% and 0% for node-positive patients (P = .04). A positive correlation with improved survival, even if not of statistical significance, was shown for other pathologic or intraoperative factors. Among the former, 5-year survival rates were better for patients with negative resection margins as compared to patients with positive margins (12% vs 7%, P = ns). Among the latter, a better actuarial 5-year survival rate was shown for patients with shorter operative time (< 4 hours, 21% survival vs > 4 hours 5%, P = ns) and for patients that received fewer transfusions (0-2 blood units, 14% survival vs 3 or more blood units, 0%; P = ns). Age, gender, tumor diameter and tumor grading showed no influence on survival in this series. CONCLUSIONS: Our series confirmed that nodal status is the strongest independent predictor of survival. Limited intraoperative transfusion, reduced operative time and clear margins could also yeald a prognostic significance, and require further confirmation in larger series.

Adult↗
PubMedDate not supplied

Ampullary carcinoma: prognostic significance of ploidy, cell-cycle analysis and proliferating cell nuclear antigen (PCNA).

BACKGROUND/AIMS: The aim of the present study is to assess the nuclear DNA ploidy patterns, the fraction of cells in the various phases of the cell cycle as determined by flow cytometry and to evaluate Proliferative cell-nuclear antigen (PCNA) expression in order to examine the relationships between phase-two molecular factors, clinicopathological aspects and outcome of patients with cancers of the ampulla of Vater. METHODOLOGY: Paraffin-embedded specimens from 18 cases of cancers of ampulla of Vater radically resected between 1985 and 1995 were analyzed by flow-cytometry and immunohistochemical staining with monoclonal antibody to the PCNA. The relationships between cell-proliferation kinetics, PCNA-positive cancer cells, clinicopathological findings and the clinical course were evaluated. RESULTS: Pathologist reports documented 17 papillary adenocarcinomas and one case of mucinous carcinoma. According to the TNM classification, 4 patients were in stage I, 7 in stage II and 7 in stage III. Locally advanced ampullary tumors (T3-T4) had a significantly worse prognosis (p = 0.01); survival at 3 and 5 years for stage I-II patients (11 cases) was 90% and 79% as compared to 42% and 42% for patients with stage III (8 cases), respectively (p = n.s.). Thirteen cancers (72%) were diploid and 5 (28%) aneuploid. Patients with aneuploid tumors were younger (mean age: 59 years) than patients with diploid tumors (mean age: 66 years; p = 0.04). No significant correlation was found between size of the tumor (T), lymphnodal status (N), grading (G) or aneuploidy. Difference in terms of survival between aneuploid and diploid patients was relevant (16 vs. 121 months) but, due to the small number of cases, was not statistically significant (p = n.s). The mean value of S-phase fraction (SPF) was 14.8%. PCNA positive rate significantly correlates with size of the tumor (T1-T2 vs. T3-T4; p = 0.03). Actuarial overall survival resulted in 70%, 63% and 31% at 1, 5 and 10 years, respectively. The high rate of diploidy (72%) supports the relative benign behavior of ampullary cancers. CONCLUSIONS: PCNA positive rate significantly correlates with size of the disease. Aneuploidy, although without significant prognostic value, correlates well with survival. Because of the wide range of all variables, more data are needed to establish the relationships between pathological factors, DNA ploidy and PCNA rate and their significance as molecular predictors of prognosis in ampulla of Vater cancers.

Adult↗
PubMedDate not supplied

[Ultrasonography in the monitoring of internal biliary drainage using an endoscopically inserted prosthesis].

Endoscopic retrograde biliary drainage by means of transtumoral endoprostheses is an effective technique for palliative decompression of malignant biliary obstruction. However, serial follow-up is required for an early detection of eventual long-term complications. In the present study 37 patients with malignant biliary obstruction, treated by endoscopic insertion of one or more biliary stents, were prospectively evaluated by sonography, with serial clinical and US examinations up to 10 months. In our experience, sonography could correctly identify both the endoprostheses and their location in the biliary tract. Most important, sonography has proved to be a sensitive method to detect possible stent dysfunctions, besides providing with information about the progression of the underlying malignancy.

Adenoma, Bile Duct↗