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Biomedical subjects

J Chipponi

Publications and source records attributed to J Chipponi.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Spontaneous hematoma of the liver in pregnancy: non-surgical treatment. Favorable outcome apropos of a case].

The authors report a case of spontaneous rupture of the liver during pregnancy which occurred in a 31-year old multiparous woman with pre-eclampsia. In the literature, this rare event is associated with both maternal and fetal high mortality rates. Histopathological studies have shown periportal parenchymal lesions, larger sinusoidal fibrin deposits and hemorrhagic infarctions. Our case was successfully managed with termination of pregnancy by cesarean section without surgical procedure toward subcapsular hematoma. Long term follow-up using liver scans is needed.

Adult↗
PubMed1989

[Retroperitoneal perforation of duodenal ulcer responsible for abscess].

The authors report a case of retroperitoneal perforation of a duodenal ulcer. This is a rare condition which is exceptionally responsible for abscess formation. If often has a poor prognosis. In the present case, the abscess was infrahepatic. The diagnosis of the origin of the abscess was established by radiological opacification via percutaneous puncture. Surgical drainage and irrigation performed via an extraperitoneal approach centered over the cavity, combined with triple-agent antibiotic therapy (penicillin, gentamicin, metronidazole) ensured collapse followed by sterilisation of the abscess cavity. The ulcer was cured by medical treatment. This case differs from the published case in terms of the diagnostic procedures classically used (upper gastrointestinal endoscopy and small bowel series), the infrahepatic site of the abscess and the extraperitoneal surgical treatment which avoided dissemination to the peritoneal cavity.

Abscess↗
PubMed1988

[Sarcomatous recurrence of leiomyoma of the inferior vena cava].

In a 63-year old woman, a surgically removed leiomyoma of the inferior vena cava recurred, 4 years later, as a leiomyosarcoma. These two smooth muscle tumours, one benign the other malignant, seldom involve the inferior vena cava. Both produce few clinical symptoms and therefore are belatedly diagnosed, except for suprarenal or retrohepatic lesions which rapidly exhibit signs of compression. Computerized tomography, angioscans and cavography are necessary to make a provisional diagnosis and determine the operative strategy. The differential diagnosis between leiomyoma and leiomyosarcoma rests on cellular or nuclear atypias, mitotic index and sometimes cytological and staining details showing the myofibril. These tumours develop slowly in the renal segment. Treatment is primarily surgical. The case reported here raises the problem of the leiomyoma-leiomyosarcoma sequence: are we confronted with degeneration, or is there such a thing as a smooth muscle fibre disease?

Diagnosis, Differential↗
PubMed1988

[Spontaneous hepatic hematoma during pregnancy].

Spontaneous hepatic haemorrhage is a rare complication in pregnancy. It usually occurs in multiparous women who have toxaemia of pregnancy. We give a case history of a primigravid patient who was not toxemic. The hepatic haemorrhage presented as blood in the peritoneal cavity which in turn gave rise to abdominal pain with hypovolaemic shock. The surgical treatment consisted in removing the segment of the liver that had been bleeding. The physiopathology of hepatic haemorrhage as described in the literature shows that there was evidence of consumptive coagulopathy with coalescence of periportal areas of liver necrosis. Treatment therefore is that of hepatic trauma. Maternal mortality runs at 70%.

Adult↗
PubMed1984

[Cystic abdomino-mediastinal lymphangioma. Apropos of a case. Review of the literature].

A further case of cystic lymphangioma is reported, characteristic features being the multiple abdominal and thoracic localizations of the lesions. Apart form splenic sites, it is rare to detect lesions in the mesogastric and mediastinal regions, particularly as propagation of abdominal lymphangioma towards the mediastinum is an exceptional occurrence. A literature review provides data on the various regions in which cysts have been reported in the body, and the diagnostic problems they raise.

Abdominal Neoplasms↗
PubMed1983

Radioenzymatic assay for direct measurement of plasma pyridoxal 5'-phosphate.

A radioenzymatic assay for measurement of pyridoxal 5'-phosphate (PLP) is described, based on the incubation of L-[3H]tyrosine (10(6) cpm, spec. acty. 1.88 Ci/mol) in the presence of the apoenzyme tyrosine decarboxylase (EC 4.1.1.25) from Streptococcus faecalis and PLP in phosphate buffer (0.1 mol/L, pH 5.5) at 37 degrees C for 60 min. The decarboxylated metabolite formed, [3H]tyramine, was selectively extracted into ethyl acetate, and the tritium radioactivity in the sample was determined by liquid scintillation counting. As little as 0.5 nmol of PLP can be detected per liter. The assay is specific, no cross reactivity having been noted for several compounds closely related to PLP. With this we could directly measure the concentrations of PLP in plasma without prior deproteinization and ether washing of the samples. Using the assay to determine plasma concentrations of PLP in healthy adult populations, we found results that were comparable with previously reported data.

Apoenzymes↗
PubMed1982

The incidence and natural history of thrombus in the portal vein following distal splenorenal shunt.

The incidence of thrombus formation in the portal vein following distal splenorenal shunt was 4% occlusive and 14% nonocclusive from 1974 to 1977, and 6% occlusive and 22% nonocclusive in 1980. The increased incidence was probably due to more aggressive ligation of collaterals on the portal vein. Ten patients with this complication were evaluated prospectively with clinical and biochemical parameters, angiography, and nutrient hepatic perfusion. In this group, one thrombus was occlusive immediately after operation, and nine were nonocclusive: eight of the latter resolved by six months, but one progressed to total thrombosis. There were no demonstrable adverse clinical or biochemical sequelae. Angiography showed continuing portal perfusion in the face of nonocclusive thrombus, but at six months there was increased collateral formation and significant (p less than 0.05) reduction in portal vein diameter, from 20 +/- 4 mm to 14 +/- 5 mm. Nutrient hepatic perfusion at six months, 896 +/- 257 ml/min, was not significantly different from that seen prior to operation, 848 +/- 92 ml/min. It is concluded that the natural history of nonocclusive portal vein thrombus after distal splenorenal shunt is resolution, and management should be expectant.

Adult↗
PubMed1981

Hypotyrosinemia, hypocystinemia, and failure to retain nitrogen during total parenteral nutrition of cirrhotic patients.

Six patients with gastrointestinal malabsorption and 12 with alcoholic cirrhosis received total parenteral nutrition for 4 wk. Freamine II, the source of the amino acids, is nearly devoid of cystine and tyrosine. We monitored daily nitrogen balance and other nutritional parameters and 22 plasma amino acids. Malabsorbers had a strongly positive nitrogen balance and improvements in nutritional parameters. Plasma amino acids were maintained within or above their normal fasting ranges. Eight of 12 cirrhotics resembled malabsorbing patients in terms of positive nitrogen balance, improved nutritional parameters, and plasma amino acids. In 4 cirrhotics, nitrogen balance remained negative and nutritional repletion failed to occur. Plasma cystine and tyrosine fell to below 30% of their normal fasting means. In 2 of these patients, oral supplements of cystine and tyrosine were given during the fifth week of parenteral nutrition. Plasma cystine and tyrosine were normalized, nitrogen balance became positive, and other repletion indicators demonstrated recovery. We conclude that in 4 cirrhotics, repletion was blocked by deficiencies of cystine and tyrosine, resulting from hepatic inability to synthesize cystine from methionine and tyrosine from phenylalanine.

Amino Acids↗
PubMed1978

[Instrumental technics of exploration of the mediastinum].

Several techniques can be used for the diagnosing of diseases pertaining to the mediastinum. The diagnosis can be made in 78% of cases by mediastinoscopy. When the lesion is situated beyond the reach of mediastinoscopy, needle biopsy and pleuroscopy can be used either alone or associated to mediastinoscopy. The histological diagnosis can be made in almost all cases. But a few precautions are necessary because this technique carries a certain risk for vessels. Therefore preoperative angiography of the superior vena cava or arteriography of the branches of the aortic arch should be performed to help for the diagnosis and ensure its safety.

Biopsy, Needle↗
PubMed1978

[Role of surgery in the treatment of deep venous thrombosis of the lower limbs and prevention of pulmonary embolism].

Besides anticoagulants and thrombolytic drugs, surgery should be included among the therapeutical means to prevent deep phlebitis of the lower limbs. Early phlebography, thoroughly innocuous, is necessary to any coherent therapy. The prevention of pulmonary embolism which can be done by a ligature of the inferior vena cava or by the fitting of an umbrella-shaped filtre, is performed most of the time with a clamp of Adams and de Weese. Its reliability is satisfactory as the percentage of embolic recurrences does not exceed 5%. Early venous thrombectomy prevents in 60 to 80% of cases the post-phlebitic incidents; but its indication must be reserved to young patients.

Humans↗
PubMedDate not supplied

Laparoscopic cholecystectomy: an original three-trocar technique.

At present, laparoscopic cholecystectomy is the treatment of choice for gallbladder stones. The operating technique reported by most authors includes the use of four trocars. We report a group of 710 consecutive patients treated by an original three-trocar technique. The use of the fourth trocar was necessary in only 55 cases (8%). However, among 56 cases of acute cholecystitis the use of the fourth trocar was necessary in 14 cases (25%) (p < 0.01). Twenty-six laparoscopies were converted to open procedures (3.6%). Four common bile duct injuries were observed (0.5%): two of them among the 655 operations with three trocars (0.3%) and two after application of the fourth trocar at the beginning of the procedure because of dissection difficulties. Our results are similar to those using the "classic" four-trocar technique. Moreover, this technique is less expensive and allows one less scar.

Acute Disease↗