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Biomedical subjects

L Gandolfi

Publications and source records attributed to L Gandolfi.

At least 55 records · Page 3Linked to original sources

Echo-guided fine-needle biopsy of pancreatic masses.

Aim of this study was the evaluation of percutaneous echo-guided fine-needle biopsy in the diagnosis of focal lesions of the pancreas. In patients with masses of the pancreas 43 echo-guided fine-needle punctures have been performed. In 27 of the 30 cases of cancer, echo-guided puncture allowed aspiration of cells revealing malignancy. In the remaining three cases the histology was normal. Malignancy was not detected in the aspirate of any of the 13 cases of benign solid masses. In one of these patients we failed to obtain sufficient material for the purpose of diagnosis. The sensitivity of the method was 90%, the specificity 100%, and the diagnostic accuracy 92.8%. Positive and negative predictive values were 100 and 75%, respectively. No complications worthy of note occurred.

Adenocarcinoma↗

Indications for laparoscopy before and after the introduction of ultrasonography.

We compared the outcome of laparoscopy performed from 1973 to 1974, prior to the introduction of routine ultrasound diagnostics, with that of examinations during the period 1980-1981 when ultrasound had become a well-established technique in the diagnosis of hepatic lesions. Our data reveal statistically significant changes in the use of laparoscopy in the diagnosis of cholestasis and tumors of the hepatic parenchyma. Laparoscopy now has fewer indications in the study of the jaundiced patient with suspected extrahepatic cholestasis which is easily identified at ultrasound. Given the high sensitivity and specificity of ultrasonography in detecting metastases, laparoscopy has become a secondary examination. However, there has been an increase in the use of laparoscopy to identify benign hepatic lesions, particularly hemangiomas.

Biliary Tract Diseases↗

Triletide and ranitidine for the management of chronic duodenal ulcer: a controlled clinical investigation.

Twenty out-patients with active, chronic duodenal ulcer were treated over a period of 6 weeks with either 0.6 g ranitidine per day or 2 g triletide per day, a new synthetic tripeptide shown to be effective in healing ulcers by increasing the mucosal defence mechanisms. Efficacy was assessed by scoring the intensity of day and night pain before, after 2 and after 6 weeks of treatment, and by endoscopy before and after. Tolerance was assessed by routine laboratory tests, physical examination and a survey of any accessory symptoms. Both drugs significantly relieved pain almost at the same rate and to the same extent, whereas endoscopy showed a not significantly greater improvement in the ranitidine group. It was found, however, that the patients in the triletide group had, on average, a significantly greater intensity of intractable factors on entry than those in the ranitidine group (+75%; p less than 0.02). After stratifying the intractability factor intensity, the 5 patients in the triletide sub-group comparable with those in the ranitidine group exhibited exactly the same behavior on pain relief and a very similar one on endoscopy findings (2 healed, 2 improved and 1 unchanged, compared with 7 healed and 3 improved, respectively). The sub-group with greater severity also showed improvements, both symptomatic and endoscopic, but to a lesser extent, indicating the need for prolonged treatment. Tolerance was good with both drugs. Two patients on triletide reported adverse effects; 1 of increased intensity of previous constipation and the other 1 of mild headache and dizziness, but these could not be related definitely to treatment.

Adult↗

The value of ultrasonography in the diagnosis of hepatic haemangiomas.

The following ultrasonographic (U.S.) patterns were observed in 21 cases of proven hepatic haemangiomas: 1) Hyper-echoic (6 cases); 2) Hypo-echoic (4 cases); 3) Complex (11 cases). Several characteristic aspects of the echo structure (uneven appearance and fine internal parallel echoes) and the location of the lesion (para-caval or sub-diaphragmatic) may be useful for differential diagnosis with malignant neoplasia. The U.S. findings of a further 17 cases of hyperechoic focal lesion of the liver are reported. Although a definitive diagnosis was not possible in these subjects, the U.S. characteristics which remained unchanged for over 6 months, made the diagnosis of haemangioma highly likely.

Adult↗

Ultrasonography in the diagnosis of portal hypertension: diminished response of portal vessels to respiration.

This study assesses the usefulness of ultrasound in the diagnosis of portal hypertension due to hepatic cirrhosis. Seventy-nine patients with portal hypertension and 45 control subjects underwent ultrasonography. Two factors were measured: (a) the caliber of the portal vein and (b) the caliber variation of the splenic and superior mesenteric veins during respiration. A lack of normal caliber variation (an increase during inspiration and a decrease during expiration) in these vessels is put forward as an ultrasonographic sign of portal hypertension, and the pathophysiological and clinical significance of this finding are discussed. The sensitivity of ultrasound in detecting portal hypertension, based on the measurement of caliber variation, was 79.7%, and the specificity was 100%. In contrast, the sensitivity of the method, assessed on the basis of portal dilatation, was only 41.8%.

Humans↗

Ultrasound in the diagnosis of cholestatic jaundice.

A total of 70 cases of cholestatic jaundice have been studied by gray scale ultrasonography in order to evaluate how this technic may be used to differentiate between intra- and extrahepatic cholestasis. In 37 out of 42 patients (88.1%) with jaundice of extrahepatic origin, dilatation of the biliary tree was demonstrated, whereas in all the 28 patients with intrahepatic cholestasis biliary dilatation was clearly excluded. In addition, gallstones in the biliary ducts were detected in 12 out of 20 cases and enlargement of the head of the pancreas (due to carcinoma or chronic pancreatitis) was often correctly diagnosed (nine out of 13 cases). These results suggest that ultrasonography should represent the first step in the diagnostic approach to cholestasis. Information gained from this noninvasive technic should make it possible to correctly plan the more complex investigations (endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography).

Adult↗