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L Cattelani

Publications and source records attributed to L Cattelani.

52 records · Page 3Linked to original sources
PubMed1994

[Tumors of the thoracic wall. Our experience].

Chest wall tumors are rare being less than 1% of all the neoplasms. While the treatment of benign tumor and of solitary metastatic is standardized, the therapy of the primary malignant is not the same for all the authors. From January 1980 to December 1993 46 patients affected by chest wall neoplasms, 29 men (63%) and 17 women (37%), mean age of 51 yrs. (range 31-77 yrs.), were treated surgically. For benign tumors only resection was performed while for malignant and metastatic tumors after the resection the reconstruction was performed respectively: in 11 cases with Marlex mesh, in 1 case with the omentum, in 2 cases with Marlex and Methyl Methacrylate. Muscle transposition was performed in 1 case with pectoralis major covering a Dura Mater prosthesis. We have no peroperative death and no complications in 37 (80%) patients. Minor complications in 9 cases; in 1 case the sternal prosthesis was removed for infection. The median follow up was of 40.50 months. Actually the 48% of patients with primary and metastatic tumor are alive. From our results we conclude that the wide radical resection with reconstruction when necessary is the treatment of choice for the tumors of the chest wall.

Adult↗
PubMed1994

[The obturator hernia: a diagnostic challenge?].

Obturator hernias are relatively rare. Elderly women with chronic diseases are most frequently affected. Mechanical small bowel obstruction is the most common presenting symptom. Cause the Howship-Romberg sign is found in only 20% of cases, a correct preoperative diagnosis is uncommon. Midline abdominal incision is thought to be the better approach, allowing an easy reduction of the incarcerated ileum and a direct repair of the defect. Contralateral side exploration is recommended, being bilateral hernias quite common. The prognosis, despite our own results, remains severe for the compromised general conditions of the great majority of the patients.

Female↗
PubMed1994

The influence of high and low doses of diltiazem on isolated alveolar type II cells during normothermic and hypothermic ischemia: cytoprotection or cytotoxicity?

The alteration of calcium homeostasis is of outstanding importance for the cytotoxic reactions that place after ischemia, for this reason calcium channel blockers have been used with the purpose to protect the lung during transplantation. This work analyses the effect of Diltiazem at two different doses (10 mg/l and 50 mg/l) on Wistar rat alveolar type II cells, incubated for 8 hours at 37 degrees C and at 4 degrees in an electrolytic solution. Total protein content and the rate of protein synthesis derived from 35S Methionine uptake were used to evaluate cells viability. The data showed that Diltiazem did not improve cellular viability after warm and cold metabolic ischemia either using 10 mg/l or 50 mg/l, while at 4 degrees C a significantly cytotoxic effect (p < 0.05) was observed. At this temperature toxicity was independent on the dose used.

Animals↗
PubMed1993

[Analysis of type II pneumocyte protection by pneumoplegic solutions. An experimental in vitro study of lung preservation for transplantation].

With the aim of studying the physiopathological mechanism of lung preservation, we have valued the Pneumocytes Type II viability after six hours of incubation at 4 degrees C in extracellular (Ringer Lactate) and intracellular (Collins, Euro-Collins and Belzer) solutions. The cells have been cut off from adult rat's lung using the modified Dobbs' method. Alveolar Type II viability have been valued using two methods: the total protein content in each culture and the metabolic function of the cells using the rate of protein synthesis by means of 35 S methionine uptake assay. The results have demonstrated a significant difference (p < 0.05) using extracellular solution instead of intracellular. Besides, we have observed a better Pneumocytes Type II survival during Belzer's solution incubation comparing with Collins and Euro-Collins (p < 0.05). Pneumocytes type II require for a better preservation a specific solution that must be similar to extracellular fluid and added with substances able to minimize noxious events during preservation.

Albumins↗
PubMed1993

Contralateral spontaneous pneumothorax after single lung transplantation for fibrosis.

The authors report the treatment of a case of contralateral spontaneous pneumothorax during single lung transplantation. This is a unusual complication that must be treated to avoid life-threatening problems. There is no consensus of opinion on therapeutic procedures. This work underline the success obtained with a simple thoracostomic drainage.

Adult↗
PubMed1993

[Evaluation of the clinical efficacy of misoprostol for gastric cytoprotection in patients under treatment with NSAID after proctologic intervention].

To perform ambulatorial surgery with local anaesthetics, it is important to carry out a correct postsurgical NSAID therapy avoiding the risks induced by these drugs. Two groups of patients submitted to ambulatorial hemorrhoidectomy were enrolled in a randomized study to evaluate the safety of NSAID therapy with or without the coadministration of misoprostol, a PGE1 analogue with gastroprotective action. Aim of this study was to evaluate if misoprostol in coadministration with NSAID could permit a correct domiciliary postsurgical NSAID therapy without gastric symptoms related to the NSAID therapy. From January 1990 to December 1991, 95 patients underwent hemorrhoidectomy and were discharged with analgesic therapy: the first group (n = 45) without gastroprotective therapy, the second group (n = 50) with the coadministration of misoprostol 200 mcg bid. After 7 and 14 days of treatment patients showed the following symptoms: in the first group 13.3% of the cases showed mild epigastric pain, 8.8% moderate epigastric pain and 4.4% severe epigastric pain with heartburn; in the second group (NSAID + misoprostol) only 4% of the cases showed moderate epigastric pain. The incidence of epigastric pain was statistically higher (p < 0.05) in patients treated with NSAID alone in comparison with the group treated with NSAID + misoprostol. The results, according to international literature, show that correct gastro-protective therapy with synthetic prostaglandins (misoprostol) is necessary for patients in treatment with NSAIDs.

Adult↗
PubMed1992

[Videothoracoscopic treatment of spontaneous pneumothorax].

In the period between May and October 1992 we have admitted in our department 14 patients (M/F: 11/3) with recurrent spontaneous pneumothorax, being the entity more than 40% in 8 of them. All the patients were treated with video-assisted thoracoscopic pleurectomy, beginning from the 2nd to the 6th rib, completing by abrasing the further ribs below. Whenever the causative bullae or blebs were found, those were resect using and endoGIA. At the end of the procedure a pleural drain (no. 24) was positioned and maintained on suction until a complete lung reexpansion was ensured for at least a couple of days. Neither postoperative nor delayed complications and no recurrences have been observed. Our results of such an approach, once indicated the pleurodesis for the treatment of spontaneous pneumothorax, are undoubtedly encouraging both for the technical simplicity and the reduction in hospitalization time.

Adult↗
PubMed1992

[Videothoracoscopic wedge resections of the lung].

The recent development in thoracoscopic instrumentation has widely improved their surgical applications so to allow lung resection whether for diagnostic of therapeutic purpose. From June to December 1992, we performed 14 segmental atypical lung resections in 12 patients. The indications were: recurrent spontaneous pneumothorax due to bullae or blebs in 7 cases, solitary peripheric lung nodule in 6 cases, for diagnostic purposes in suspicious interstitial lung disease in one case. Lung resection were carried out using stapling device (EndoGIA). In the cases of solitary lung nodule, the frozen section confirmed the presence of metastases in 4 subjects and thus it was proceeded towards an exploratory mini-thoracotomy (3 cm long) so to allow a further palpatory video-assisted evaluation of the lung surface. The remaining 2 patients were diagnosed to have hamartomas. The wedge resection in the patient with interstitial lung disease allowed diagnosis of sarcoidosis. There were no postoperative complications, nor deaths. Video-thoracoscopic lung wedge resections are indicated for treating bullae and blebs while performing pleurectomy for spontaneous pneumothorax, for removing benign and metastatic peripheral lung nodules. The procedure is substantially diagnostic in case of interstitial lung diseases. It's important to underline that the therapeutic value of thoracoscopic approach for metastatic lung nodules has not proved to be less or more efficient than the thoracotomy one and for this reason further investigations are required.

Adenocarcinoma↗
PubMed1992

[Videothoracoscopy in diagnosis and treatment of chronic pleural effusions].

Thoracoscopy is the most important method for the diagnosis, and in particular cases for the treatment, of chronic pleural effusion of unknown aetiology. The Authors report their experience of 4 cases, 2 males and 2 females, that underwent a thoracoscopy from June to December 1992. The method was done in 3 cases in general anesthesia and in one case in local anaesthesia.

Aged↗
PubMed1989

[Significance of explorative thoracotomy in the diagnosis and symptomatic treatment of bronchogenic carcinoma].

Diagnostic imaging and mediastinoscopy have reduced but not eliminated the exploratory thoracotomy in the management of lung cancer patients. Considering all the limits of such diagnostic techniques, an aggressive approach to lung neoplasm imply an increase both in explorative thoracotomies and in radical or palliative intraoperative procedures. Our study includes 55 explorative thoracotomies performed on 206 surgical operations for lung cancer. The patients of E.T.'s group couldn't undergo surgical resection in 28 cases because of direct tumoral mediastinal diffusion, involving cardio-pericardial wall and/or great vessels; in 20 for extensive nodal mediastinal diffusion, in 3 patients for pleural dissemination, and 4 had unresectable chest wall involvement. Postoperative mortality rate was 3.6% vs. 5.5% recorded in resected patients; postoperative morbidity rate was 9%. During explorative operations became possible to define more exactly diagnosis and, through palliative procedures, to improve life quality: in fact we performed tumor histology correction or settlement (12/55 P.ts), pericardiotomy for pericardial effusion (5/55 P.ts), pleurodesis or pleurectomy when pleural effusion was present (16/55 p.ts), intercostal neurolysis in involved chest wall areas (4/55 p.ts).

Adenocarcinoma↗
PubMed1988

[Localization of hydatid cysts in the left hemidiaphragm. Description of a case].

The authors studied a 43-YR. old woman with a hydatid cyst, localized in the left diaphragm and extending into the left lung and the liver. De to difficulties in diagnosing the type, location, and extension of the lesion and its nonspecific symptoms, hydatid cysts are frequently not considered outside the endemic areas when formulating a differential diagnosis. Chest and abdominal CAT scanning permits a satisfactory definition of both the type of process and its topographical relationships. This permits the most appropriate surgical route to be chosen in performing a left thoracotomy in order to surgically afford the abdominal component of the cyst. This proved easy to remove, despite the existence of a tangle of adhesions, and had a favourable outcome, both immediately after surgery, and with long term follow-up.

Adult↗
PubMedDate not supplied

The effect of verapamil and diltiazem on alveolar type II cells during warm and cold metabolic ischaemia.

The alteration of cytosolic free calcium concentration is an important event during cellular ischaemia. Calcium channel blockers have been shown to be beneficial during experimental ischaemic organ protection. To investigate the mechanisms of this protection, the behaviour of type II pneumocyte cultures, subjected to warm and cold metabolic ischaemia (6 h), was studied. The cells were incubated in electrolytic solutions and treated with high doses of verapamil (10 mg/l) or diltiazem (100 mg/l). Alveolar type II epithelial cells were removed from adult rat lungs using the modified Dobbs' method. Cell viability was determined by analysis of the total protein content, and from the rate of protein synthesis as indicated by the [35S]methionine uptake assay. The results show that verapamil does not have a direct cytoprotective or cytotoxic effect on the incubated cells, but diltiazem seems to be toxic to the cells, especially during cold ischaemia when the toxicity is significant (P < 0.05). Thus, the protection from ischaemia previously attributed to calcium channel blockers is ascribed to action on the blood vessels resulting in vasodilatation, rather than to a direct influence on cytosolic free calcium homeostasis.

Animals↗
PubMedDate not supplied

Pulmonary endothelial cell modifications after storage in solid-organ preservation solutions.

During lung preservation, the vascular endothelium is probably the first site of damage and these lesions are considered the main limiting factor in solid-organ preservation. In the present study, the ultrastructural changes in the endothelial cells of human pulmonary artery hypothermically stored (at 4 degrees C) for 6 and 12 h in Euro-Collins, University of Wisconsin and Ringer-lactate solutions were compared. The arteries obtained from three patients who underwent pneumonectomy were divided into 20 segments and preserved in the three solutions mentioned. The specimens, which were fixed in osmic acid, were examined using transmission electron microscopy. Transmission electron microscopy indicated that the cells stored in the University of Wisconsin solution either for 6 or 12 h were the best preserved, while the most severely damaged cells were those stored in Euro-Collins solution, even after just 6 h. The cells stored in Ringer-lactate showed an intermediate level of damage. The data from an ultrastructural grading scale, which quantified the damage to the cytoplasm, mitochondria and nucleus, were in broad agreement with the general transmission electron microscopy observations. Analysis of variance of the grading scale data showed that there were statistically significant differences between the groups after both 6 and 12 h storage (P < 0.05).

Aged↗