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Biomedical subjects

L Greco

Publications and source records attributed to L Greco.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

[Carotid body tumors: an analysis of 10 cases].

Some problems of carotid body tumors regarding diagnosis and treatment are still controversial. From 1988 to 1998 we operated on 10 cervical paragangliomas in our Division of Vascular Surgery of Bari University. Three were bilateral and 2 were II Shamblin class. Seven tumors were considered familiar type (5 patients in the same family). Subadventitial dissection was performed in all cases after 4 vessel angiographies and Echo-dopplers. No complications occurred during the operation or post-operatively. Operative bleeding was reduced significantly by the use of subadventitial dissection which was accomplished in short times, thus avoiding more complicated and even hazardous techniques like clamping, sectioning or ligatures of the external carotid artery.

Adult↗
PubMedDate not supplied

[The emergency treatment of aneurysms of the supra-aortic trunks and of the internal carotid].

In the last 10 years, four patients with aneurysms of the supraaortic trunks and the internal carotid artery have been operated in emergency at Department of Vascular Surgery of University of Bari. The first case was a mycotic aneurysm of the carotid bifurcation, the second an aneurysm of internal carotid artery interesting the retropharynx, the third a post-operatory pseudoaneurysm of common carotid in a patient affected by Takayasu's disease and the last an atherosclerotic aneurysm of the innominate artery. Clinical picture suggested an immediate surgical treatment in all patients. Different procedure were used depending on size and localization of each lesion. Results in all cases have been satisfactory. The aneurysms of supraaortic trunks and of internal carotid artery are very rare; therefore when clinical picture is dramatic or quickly worsening, emergency treatment is mandatory in order to reduce mortality risk and minimize complications.

Adult↗
PubMedDate not supplied

[Treatment of hemorrhoids with circular mechanic stapler].

In a pilot study undertaken in collaboration with the Department of Surgery of "San Carlo di Nancy" Hospital in Rome, over the period form January 1998 to February 2000, 128 patients with haemorrhoidal disease underwent surgery using a circular stapler to "lift" the mucous-haemorrhoidal prolapse, according to the pathogenetic theory discussed here below. We compared the results of our series with those of a retrospective series of 80 patients that undergoing traditional surgery (Khubchandani 45, Milligan-Morgan 30, Whitehead 5), evaluating length of operation, postoperative pain and complications. Our preliminary data show that the technique requires only a short learning period, reduces the length of the operation, reduces the medium- and long-term pain and allows mables the patient to resume full working activity earlier.

Adult↗
PubMedDate not supplied

[Expression of epithelial oncoproteins in large intestine neoplasms].

The high incidence of the colorectal cancer in the industrialized countries has drawn the interest of the scientific community to detect and investigate its morphologic precursors. Growth factors and oncoproteins could be useful to investigate the morphologic and biologic evolution of precancerous lesions of the large bowel. Therefore the Authors report the results obtained from 30 selected patients with hyperplastic and adenomatous polyps, and different histotypes of colorectal cancer, investigated using the EGF-r and p62 protein expression. The results show the potential usefulness of such markers to evaluate the biology of intestinal tumors.

ErbB Receptors↗
PubMedDate not supplied

[Thyroid carcinoma. Criteria for the selection of surgical treatment].

Surgery is still today the first choice treatment in the thyroid neoplasm. The authors examined 37 patients with thyroid cancer out of 389 thyroidal operation performed in the period 1982-85 at the Institute of Surgical Pathology II and Surgical Clinic of University of Bari. The pro-operation screening was scintigraphy, US study and needle biopsy. In 23 case, with positive cytology examination and/or clinical malignancy the performed operation was total extracapsular thyroidectomy. Other nine patients underwent lobectomy and in 2 cases the operation chosen was sub-total strumectomy completed by thyroidectomy after histologically proved malignancy. The laterocervical lymphadenectomy was done only in the case of nodes involvement. Operative mortality was 0 and post-operative stay was about 6 days. The extracapsular total thyroidectomy is the first choice operation for cancer. Nevertheless recently some Authors proposed less destructive operation in the small differentiated type cancers with good results.

Adenocarcinoma↗
PubMedDate not supplied

[Breast cancer in advanced age].

The incidence of breast carcinoma increases with advancing age. In view of the progressive aging of the population, this problem will tend to become more and more frequent. At present, patients of advanced age are often "undertreated" owing to the mistaken prejudice that older patients are unable to withstand standard multimodal therapy for this disease. In fact, there is no scientific evidence to that effect. Treatment choices should therefore be largely comparable to those adopted in younger patients. Even chemotherapy, which encounters the strongest resistance, by patients but also by doctors, should be administered when indicated. A number of studies have demonstrated that the toxic and side effects observed in elderly patients are comparable to those observed in younger age groups. In practice, particular attention needs to be paid when administering cytostatic treatment to patients over 80 years of age. Very conservative treatment (tamoxifen plus radiotherapy) may be reserved only to particularly frail elderly patients. In conclusion, the therapeutic choice should depend more on assessment of the biological age, life expectancy and patient's expectations than on the anagraphic age.

Age Factors↗
PubMedDate not supplied

[Carotid endarterectomy in the elderly].

The elderly population has the highest risk for developing stroke and the annual death rate is some 394/100,000 population. Moreover, the elderly are the fastest growing segment in our society. In carefully selected patients carotid endarterectomy may provide to prophylaxis against stroke. With a careful selection, acceptable low operative motality and morbidity rates may be achieved, comparable to the 4.3% and the 2.3% of the Veterans Affair and ACAS studies, in which the patients' mean ages were 64.1 and 67 years respectively.

Aged↗
PubMedDate not supplied

[Endovascular treatment of aneurysms in the elderly].

The constant increase in the median age over 80 requires more and more care from vascular surgeons to obtain better results in the treatment of aortic degenerative diseases. In the last years a remarkable improvement in the procedures of endovascular surgery of abdominal aortic aneurysms has been reached. Actually different prostheses are available for the treatment of aortic aneurysms. The early results of these procedures are similar to the traditional surgical techniques, but at the moment long term results are not yet available. The Authors underline the importance of a long term follow up to allow a correct evaluation of physiopathological modifications in the aortic circulation.

Aged↗
PubMedDate not supplied

[Spontaneous splenic rupture due to infectious acute mononucleosis: case report].

Infectious mononucleosis is an acute, viral, illness associated with a high incidence of splenomegaly. Spontaneous splenic rupture is a rare but life-threatening complication of infectious mononucleosis. The authors report the case of a 19-year-old patient with an infectious mononucleosis causing a spontaneous splenic rupture. When rupture occurs the mortality has been significant. The spleen may be vulnerable for the histopathologic changes that occur as a result of this illness. Two thirds of patients with infectious mononucleosis develop an enlarged spleen, but in only 0.5% of all patients will it rupture. Abdominal pain and tachycardia are unusual in uncomplicated infectious mononucleosis and should alert a doctor to the possibility of spontaneous splenic rupture. The diagnosis of splenic rupture may be confirmed in a variety of ways. In this patient ultrasound and Rutkow's criteria may aid in establishing the diagnosis. In patients with infectious mononucleosis suspected of having rupture of the spleen, a rapid but thorough assessment and prompt implementation of appropriate management should minimize the associated morbidity and mortality. On the basis of review of the medical literature and of our own experience, we advocate emergent splenectomy for spontaneous splenic rupture in patients with infectious mononucleosis.

Adolescent↗
PubMedDate not supplied

[Evaluation of the role of occupational and environmental exposure to inorganic arsenic in the urinary excretion of the metal: preliminary data].

INTRODUCTION: Urinary inorganic arsenic is an expression of occupational exposure to the metal, provided that there is no history of ingestion of foods containing high concentrations of inorganic and/or organic arsenic. The present study was conducted to assess the contribution of professional and environmental exposure to inorganic arsenic on urinary excretion of the metal. MATERIALS AND METHODS: We examined 195 workers at a steelfoundry in Taranto, exposed to very low concentrations of inorganic arsenic and two control groups consisting of 105 subjects resident near the factory and 144 subjects resident approximately 20 Km away. All participants were administered a questionnaire enquiring about general characteristics, lifestyle, occupational and extra occupational exposure to arsenic. Urinary arsenic was determined by atomic-absorption spectrophotometry. RESULTS: Exposed and non exposed subjects were similar as regards general characteristics and lifestyle. The environmental concentration of arsenic for the foundryworkers was invariably lower than 0.1 microg/m3. Urinary excretion of arsenic was higher in the subjects in all three groups, examined singly and together, if they had eaten crustaceans and/or shellfish in the three days before urine collection. There was a significant positive correlation with the consumption of shellfish and a significant negative correlation with the number of days since the last crustacean/shellfish meal. Multiple regression analysis showed a dependence of urinary elimination of arsenic on the days since the last crustacean/shellfish meal. DISCUSSION: The absence of occupational exposure to arsenic allowed us to attribute the higher urinary elimination of arsenic to ingestion of crustaceans and/or shellfish in the three days before collection of the urine, both in subjects exposed to inorganic arsenic and in the two groups belonging to the general population. Our results support the hypothesis that inorganic arsenic, determined by atomic-absorption spectrophotometry, may derive from the catabolism of organic arsenic compounds contained in crustaceans and/or shellfish included in the diet.

Arsenic↗
PubMedDate not supplied

[The risk factors and prevention of recurrences in rectal surgery].

The authors report their own experience of 34 patients operated on for rectal cancer. In 8 cases abdomino perineal resection and in 26 anterior resection with anastomoses (6 in second time) were performed. Operatory mortality was nil and with an average follow up of 34 months 5 local recurrences were observed 16%. Among the risk factors examined the most important seems to be the stage of the disease; imperative it is therefore a correct surgical approach which warranted a significant reduction of local recurrences. This surgical approach includes a safety distal clearance from the tumour (at least 2.5 cm.), radical lymphadenectomy and complete removal of the mesorectum.

Adult↗
PubMedDate not supplied

[The role of fine needle biopsy in the cytologic diagnosis of thyroid nodules].

The study was conducted an 298 patients suffering from thyroid nodules who underwent FNAB and successively surgery. The results of FNAB, compared with histology showed a sensibility of the technique of 76.6%, a specificity of 100%, an efficiency of 97.3%, with a negative prognostic value of 97% and a positive one of 100%. The authors stress the role of FNAB in the diagnosis of thyroid nodules in permitting, apart from where follicular tumours are concerned, an efficient identification of malignancy.

Adolescent↗
PubMedDate not supplied

[The intraoperative visualization of the bile ducts by the use of fluorescent substances. A feasibility study].

Iatrogenic bile duct injury during cholecystectomy is the most serious complication of this surgical procedure. Initial reports suggest that this complication is particularly problematic during laparoscopic cholecystectomy. Proper identification of biliary anatomy in the subhepatic region is the only way to avoid this severe complication. The potential benefit from a simple, reliable method for intraoperative delineation of biliary anatomy is self-evident. In this experimental work the Authors-study the possibility and the feasibility of intraoperative biliary tree imaging with two fluorescent molecules (rolitetracyclin and fluorescin).

Animals↗
PubMedDate not supplied

[Incidentalomas of the adrenal gland].

The wider application of radiological examinations (ultrasound, computed tomography) has led to the pre-clinical discovery of "masses" in some organs, especially in adrenal gland. As these tumors are incidentally discovered, they are called "incidentalomas", and this term has been universally accepted. As soon as adrenal incidentaloma has been diagnosed it is important to establish if the patient has to undergo immediate surgical exploration or it is possible to follow the patient radiologically. Hormonally active adrenal metastatic tumors and adrenal incidentalomas greater than cm 5 should be surgically treated, while other adrenal tumors can be followed radiologically. Median anterior laparotomy or bilateral subcostal incision give a good surgical view. It is important the cooperation with endocrinologist, cardiologist and anaesthetist in order to control possible hypertensive rises during surgical operation.

Adrenal Gland Neoplasms↗