[Hemodynamic value of the LES tone in the pathogenesis of bleeding esophageal varices].
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Esophageal and Gastric Varices↗
Biomedical subjects
L Giacomelli
Publications and source records attributed to L Giacomelli.
[Chronic periaortitis].
The authors, o the basis of a retrospective analysis of a series of 13 cases of chronic periaortitis, after a review of the literature about the subject, discuss about the most recent theories about pathogenesis, pathological anatomy, diagnosis and treatment of this condition. At first the authors stress the importance of adopting the term chronic periaortitis to describe any idiopathic fibrotic retroperitoneal process, as a consequence of the well established relationship between the atherosclerotic abdominal aorta an the development of this condition. Histological, immunohistochemical and immunological studies, consented to clarify the pathogenesis o the lesion. CT or MRI currently makes the diagnosis but histological confirmation is desiderable. Surgical therapy plays still a fundamental role in the management of chronic periaortitis, but the use of immunosuppressive drugs is to be considered extremely promising.
Aorta, Abdominal↗
[Scintigraphy with 99mTc-HMPAO-marked leukocytes and abdominal tumors: clinical interpretation of scintigraphy results].
The 99mTc-HMAPAO-labelled leucocyte scan is a widely employed diagnostic tool in the assessment of inflammatory and infective diseases. Nevertheless, leucocytes accumulation in neoplastic lesions has been reported. In the present study, aimed at the exploration of the abdomen and performed on 62 patients, positive scintigraphic findings were obtained in 66.6% (4/6) of the neoplasms and in 6.45% (4/62) of the studied cases. These scintigraphic results, even if they have to be considered as false positive cases, effectively reflect histopathologic changes present in the neoplastic tissue. On the basis of the obtained results, leucocytes accumulation in abdominal malignancies is probably due to the presence of necrosis and ulceration and to the resulting infection of the tumour.
Abdominal Neoplasms↗
[The megacolon in myotonic dystrophy: case report and review of the literature].
Myotonic dystrophy (MD) is an autosomal dominant inherit disease, slowly progressive, involving multiple organ systems. Disorders at any level of the gastrointestinal tract are relatively common and manifest as disturbances in motility, such as impaired esophageal transport, delayed gastric emptying, and megacolon. A 51 years-old man was admitted to our surgical department with obstructive symptoms. Diagnostic evaluation showed megacolon and the typical clinical features of the MD, such as weakness, myotonia, frontal baldness and testicular atrophy. Risk of perforation and dehydration led to emergency total colectomy with ileorectal stapled anastomosis. The patient didn't suffer for compliance related to surgical treatment but, after 1 month in intensive care, died of pneumonia and myocardial infarct. The overall frequency of perioperative complications in patients with MD ranges from 8.2 to 42.9%. The risk of perioperative pulmonary complications is particularly high. Thus, we believe that the conservative treatment of motility disorders of the bowel in patients with MD is to be justified and that surgical treatment should be reserved, as last resort, performing a early diagnosis and careful monitoring during perioperative period.
Fatal Outcome↗
[Breast carcinoma with neuroendocrine differentiation. Clinical case and review of the literature].
Female breast carcinoma with neuroendocrine differentiation is a lesion which can enhance of conventional therapy added with tamoxifene-octreotide association. The Authors report a case completely responsive after two years therapy, which grading was: pT4, N1biii, Mx, G2 staging III.
Aged↗
CD44v6 and Nm23-H1 protein expression related to clinico pathological parameters in colorectal cancer.
OBJECTIVE: Nm23-H1 and CD44v6 expression has been shown to be correlated with the metastatic potential of colorectal cancer (CRC) in some studies but not in others. The present study was undertaken to evaluate immunohistochemically the expression of these markers and to correlate them with clinicopathological variables. MATERIALS AND METHODS: Archival tissues of 41 non metastatic colorectal cancers were histopathologically evaluated and stained with monoclonal antibodies versus Nm23-H1 and CD44v6. RESULTS: Expression of Nm23-H1 was detected in 73% (n = 30) of all CRC, and CD44v6 in 37% (n = 15) of all CRC. CD44v6 was found to be statistically associated with tumour grading differentiation (p < 0.03), but no correlation emerged between Nm23-H1 and CD44v6 and Dukes stage, site, peritumoral lymphocytic infiltration, venous infiltrating, perineural infiltrating, tumour budding, pushing and infiltrating tumour growth. CONCLUSION: Even if the results are not statistically significant, the authors noticed that the expression of Nm23-H1 was correlated with those histopathological parameters that indicate local disease progression and metastases.
Aged↗
[New trends in the diagnosis of Crohn's disease].
The Authors in reviewing the diagnostic techniques commonly used in Crohn's disease, focus their attention on Indium-111 scanning. The method seems useful, not only to point out the complications of the disease (stenosis, abscess, fistula) but especially for the follow up of patients after surgery with early diagnosis of a possible relapse.
Crohn Disease↗
[Intermuscular and intramuscular lipomas of the neck].
Two cases of deep lipomas of the neck developed between the skeletal muscles were presented: one intermuscular and the other intramuscular. Taking into consideration the rarity of the case, the authors examined the clinical surgical aspect, paying special attention to the relationship between sonographic and computerized tomographic characteristics and the histological aspects in order to define whether the lipomatous tumors were benign or malignant. They also studied the localization of cervical lipomas, of lipoblastomas of hibernomas and of liposarcomas and defined an anatomo-clinical classification of both superficial and deep cervical lipomas.
Aged↗
[Sigma's stenosis. Clinical, diagnostic and therapeutical problems].
Sigma's stenosis represent a frequent pathology, but its very difficult to have a pre-operatory diagnosis about the nature of these stenosis, not withstanding the introduction of more sophisticated instruments of diagnosis. In this work we present 9 cases of sigma stenosis; some of these with a common etiology and other very interesting for their rare and unusual origins. The patients were underwent to a different timing of diagnosis and therapy based on clinical history and diagnostic hypotheses; our experiences demonstrate that the clinical intuition is really useful for a correct diagnosis in the patients with a sigma's stenosis and consequently, in order to plan the correct therapy.
Adult↗
Detection of human papillomavirus DNA, p53 and ki67 expression in penile carcinomas.
Our study is aimed at evaluating the presence of p53 and Ki67 expression by immunohistochemistry in a series of 11 paraffin-embedded penile carcinomas. We also investigated the presence of Human Papillomavirus (HPV) DNA in these tumours and performed an accurate typing by DNA sequencing on positive samples. Immunohistochemistry (IHC) was performed with the anti-p53 and Ki67 mouse monoclonal antibodies. DNA extracted from small sections of each specimen was submitted to amplification with HPV specific general primers; PCR products of the proper length were purified and sequenced. IHC demonstrated nuclear accumulation of mutated p53 and Ki 67 expression in 10/11 tumour samples (90.9%). The prevalence of HPV DNA was 72.7%; the most prevalent type was HPV16. Sequencing analysis revealed the presence of HPV53 (12.5%), HPV18 (25%) and HPV16 (62.5%). Out of the p53 or Ki67 positive carcinomas the percentage of HPV positives was 80% and 70% respectively. Our results indicate that penile carcinoma is frequently associated to high risk HPV and with diffuse p53 and Ki67 expression.
DNA, Viral↗
[Colonic stenosis due to a "microcarcinoma" of the ovary: a clinical note].
The authors, on the basis of a case recently observed, suggest to take into account the presence of an ovarian "microcarcinoma" when a jejunal stenosis of uncertain origin is found in a female patient. In fact, ovarian carcinoma is often misdiagnosed. A complete surgical exploration is recommended even though diagnostic techniques such as endoscopy, CT scan, ultrasonography and X-ray barium enema are negative.
Carcinoma↗
Plasma clearance of exogenous lipids in patients with malignant disease.
Abnormalities in lipid metabolism have been widely described in cancer-bearing patients and animals. In particular, the presence of the tumor seems to profoundly affect triglyceride (TG) utilization by interfering with lipoprotein lipase (LPL) activity. Exogenous TG plasma clearance was evaluated in 10 nonmalnourished patients with cancers of various origin and 10 normolipidemic volunteers by means of a three-stage intravenous lipid clearance test. This technique allows precise determination of both the fractional removal rate (K2) and the maximal clearing capacity (K1) for exogenous lipids. Mean K2 values (min-1) were found to be significantly reduced in cancer patients compared with control subjects (0.07 +/- 0.006 vs 0.13 +/- 0.013 SEM, p less than 0.005). K1 values (mumol/L/min) were also found to be significantly lower in cancer patients than in the control group (109.43 +/- 6.3 vs 143 +/- 6.3 SEM, p less than 0.01). The data obtained indicate that the capacity to eliminate exogenous lipids from the bloodstream is reduced in cancer-bearing patients. This may be the consequence of a tumor-related impairment of LPL system activity.
Adult↗
[Endometriosis. Report and clinical contributions].
The Authors, starting from the description of a clinical case of abdominal wall endometriosis, arisen subsequently to a caesarean section, take into consideration the world literature on the subject, and focus their attention on the problem of the anatomic location and the etiopathogenesis of the pathology.
Abdominal Muscles↗
[Nutritional and defunctionalized jejunostomy in the chemotherapeutic treatment of gastric non-Hodgkin's lymphoma. Preliminary experience].
The authors propose a jejunostomy on an omega loop distal to the Treitz ligament as a treatment for unresectable gastric lymphomas. The rationale is to provide nutritional support during chemotherapy in a situation when the stomach is defunctionalised. As assessed by clinical, morphological and biological parameters, the association of chemotherapy and jejunostomy may represent a valid therapeutical strategy for patients considered unresectable.
Antineoplastic Combined Chemotherapy Protocols↗
[Anorectal neuroendocrine carcinoma: observations on a case and review of the literature].
Carcinoid tumours of the anorectum are rare (0.7% of malignant rectal tumours). Because of this rarity several aspects of the management of these tumours remain controversial. Diagnosis may be delayed because of failure to recognize their morphological characteristics and histological appearance may not reflect their biological behaviour. Immunocytochemistry for neuroendocrine-cells are essential to identify different types of carcinoid tumours and to do differential diagnosis from other malignant tumours. All that allow an exact therapeutic approach to these tumours. The tumours less than cm 1 in diameter can be safely treated by local excision; the tumours more than cm 1 in diameter are treated by radical surgery (AAP).
Carcinoma, Neuroendocrine↗
[Perianal Paget's disease: clinical observation and review of the literature].
The authors present a case of PPD, stressing the importance to distinguish "true" PPD from pagetoid spread, for correct diagnosis and appropriate treatment. This distinction is possible by using immunohistochemical stains, with particular regarding Ab-GCDFP-15, considered specific marker for Paget's cell.
Aged↗
[Squamous carcinoma of the anal canal and its variations. Personal experience and review of the literature].
Six cases of anal canal squamous carcinoma are presented. The authors precise the present view about pathological, epidemiological, clinical and therapeutical aspects of these lesions. They stress, also, the primary role of embryology and anatomy in the oncogenesis of such tumours; the importance to single out specific population at risk, absolutely different from the typical one for rectal adenocarcinoma and the role of chemoradiation therapy as treatment of choice of these neoplasms. Particular importance is given to modern histologic and histogenetic classification of these tumours, stressing the difficulties to distinguish the various histologic types.
Aged↗
[Subtotal colectomy with ceco-rectal anastomosis].
A case of subtotal colectomy cecoproctostomy for multiple lesions of the colon is introduced. This procedure has advantages over ileoproctostomy because it spares the terminal ileum, ileocecal junction and cecum. Due to the high incidence of bowel movements after the ileoproctostomy operation, the authors recommend cecoproctostomy as a valid choice in a selectioned group of patients with multiple or extended lesions that spares cecum and rectum.
Aged↗