The reverse transcription/polymerase chain reaction (RT-PCR) was used to amplify a 129-bp fragment of the mumps virus F gene from strains circulating in the Siena area from 1993-1995. The nucleic acid was amplified directly from the samples; no growth in cell culture was required. Nucleotide sequence analysis and the comparison with other virus strains enabled the typing of the detected viruses. There appears to be more than one lineage of mumps virus circulating at any given time in the same location. A PCR assay coupled with the sequencing of the 5' end of the F gene seems to be a convenient method for characterizing mumps virus strains. This method, useful in diagnosis, also appears to be suitable for epidemiological studies.

Adolescent↗

PubMedDate not supplied

[Lung metastases from follicular thyroid cancer: a report of a clinical case and a review of the literature].

The authors report a case of follicular thyroid cancer in "hot nodule" with micronodular synchronous lung metastases. The treatment consisted in TT associated with radioiodine therapy at the dose of 170 mCi with remission of cancer after six months of follow-up. Follicular variant is a prognostic unfavorable factor such as synchronous or metachronous pulmonary metastases. In those patients prognostic unfavorable variants are also age over 40 years, a poor radiofixation capacity, and a lesion of diameter up 1 cm. A strictly instrumental follow-up is mandatory to obtain diagnosis in a subclinical stage. In such cases the radiometabolic therapy agree to a remission of cancer with high survival after many years. TT yet represents a "minimal" surgical treatment for an accurate radioisotopic diagnosis.

Adenocarcinoma, Follicular↗

PubMedDate not supplied

[Surgical treatment of secondary hyperparathyroidism].

BACKGROUND: Surgical treatment in the patient effected by secondary hyperparathyroidism consists in subtotal parathyroidectomy or total parathyroidectomy plus autotransplantation of parathyroid tissue. METHODS: The results obtained with surgical treatment of 6 patients observed in the years 1995-1996 are analyzed. Two glands were hyperplastic in four patients, 3 in the others. Every patient was submitted to a subtotal parathyroidectomy. RESULTS: Postoperative course was marked by transient hypoparathyroidism in one case. After 18 months of follow-up, no recurrences were observed. CONCLUSIONS: It is pointed out that in case of secondary hyperparathyroidism subtotal parathyroidectomy represents the surgical treatment of choice, according with literature data. Otherwise total parathyroidectomy plus autotransplantation, characterized by a more complex surgical technique, lead to the same results.

Aged↗

PubMedDate not supplied

[Avoidable complications in home care].

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Community Health Nursing↗

PubMedDate not supplied

[Neoadjuvant chemo-radiotherapy in the treatment of rectal cancer: preliminary results].

Many studies in the literature have confirmed the role of combined therapy in the treatment of rectal neoplasms. Aim of the Authors' study was to evaluate the efficacy of preoperative neoadjuvant radiochemotherapy in these patients. The study group consisted of 15 patients, affected by rectal adenocarcinoma T < 4 M0 with age < 75 years, observed from January to August 1998, who underwent to RT of pelvis with three fields--total dose 32 Gy- in ten days associated with 5 FU(500 mg/m2) during the first five. After restaging the patients were operated on. Anterior resections (AR) were followed by mechanical colorectal anastomosis in 10 patients, coloendoanal anastomosis in 4, while in 1 case an abdominoperineal resection (APR) was performed. The protocol was well tolerated in every patient and perioperative complications were similar to those in the control group. A considerable reduction of the mass was obtained in a great percentage of patients studied, confirmed by pathologic examination like "down staging" of cancer. In no case a complete response to the therapy was observed (pT0N0). Survival in the patients operated on for rectal adenocarcinoma in about 50% and local relapse is the most important site of recurrent disease. The aim of neoadjuvant protocol is the control of lymphatic spread and reduction rectal neoplasm allowing coloanal anastomosis in the treatment of the 1/3 inferior rectal cancer. Literature data confirm a significant decrease of local relapse, probably with a better survival. The Authors study confirms that combined preoperative therapy is well tolerated in most of the cases and it represents the protocol of choice in the patient affected by rectal cancer.

Adenocarcinoma↗

PubMedDate not supplied

[Role of ultrasound-guided percutaneous alcohol administration in the treatment of solitary cysts of the liver].

Non-parasitic liver cysts represent a frequent pathology, but rarely they cause compressive symptoms so to require a suitable treatment. The Authors report a case of solitary large cyst localized in the left liver lobe, causing compressive symptoms in a cardiopathic old woman in whom surgical treatment was contraindicated. The treatment consisted in US-guided percutaneous puncture, decompression and sclerotherapy by 300 cc of ethylic alcohol (90 degrees). The patient showed a moderate alcoholic intoxication, associated with fever. This treatment been repeated fifteen days after for the large dimension of the cyst. Twelve months later the results were excellent with a complete relief of compressive symptoms and a remarkable reduction of the cyst at the CT scan. The Authors conclude that, in case of non operable large liver cysts, percutaneous ethanol injection is the treatment of choice, with low cost and morbidity, and mild recurrence rate.

Aged↗

PubMedDate not supplied

[Primary megaureter detected during the first year of life. Review of case reports in the last 10 years and analysis of prognostic factors].

AIM: We report our experience in the treatment of primary megaureter discovered prenatally or in the first year of life. We also discuss the prognostic role of the first diuretic renogram performed immediately after the discovery of the megaureter. MATERIAL AND METHODS: 45 patients have been observed since January 1990 until December 1999, with 54 primary non refluxing megaureters (9 bilateral cases); 18 discovered prenatally; 24 detected during a postnatal echographic screening of urinary malformations; and 3 symptomatic. All the patients have been studied and followed-up with repeated sonograms and diuretic nephrograhis. RESULTS: 19 patients underwent surgery, 5 at presentation and 14 early during follow up. In this group, 7 patients were operated on because of urinary tract infection, 5 had a functional impairment of the involved kidney and 2 presented a progressive increase of ureteral size. 29 megaureters have been followed non operatively, of these, 6 resolved and 19 improved dilatation, 10 were unchanged and 3 cases underwent progressive worsening. Half time clearance (T 1/2) calculated during the first diuretic renogram had a favorable prognostic significance when the value was under 10', but when the value was above 10' the evolution was unpredictable.

Female↗

PubMedDate not supplied

[Tracheal rupture a complication of orotracheal intubation].

One of the most frequent anesthesiological manoeuvres is orotracheal intubation (OTI). Many complications can occur during OTI, one of these is the rupture of the trachea (TR) and/or of the bronchi. The aim of this study is to highlight the risk of TR during OTI. Over a period of three years of activity (1997-1999) in the Cardiothoracic Department of Pisa University nine patients we treated, eight of which were women ranging from 35 to 95 years of age. In the majority of the cases clinical signs like subcutaneous emphysema of the face and neck, hemoptysis and dyspnoea, variably combined were present. An X-ray of the thorax carried out on six patients did not permit the diagnosis. Bronchoscopy was the diagnostic examination in all nine patients. Seven cases were treated by senior anaesthesiologists, without stilet and OTI was easy. Predictive elements for difficult intubation were not observed in any case. Only one patient had a voluminous intrathoracic goitre dislocating the trachea. The nine patients were all treated surgically as they were all symptomatic and with important transmural lacerations that caused pneumothorax or pneumomediastinum. The survival percentage in the third month is 100%. Although rare TR must be suspected when clinical signs are present; bronchoscopy is the examination which permits diagnosis and a correct therapy.

Adult↗

PubMedDate not supplied

[The role of surgery in the treatment of adrenocortical carcinoma].

The authors evaluate the role of surgery in the treatment of primary adrenocortical cancer. They describe a case-report of a "giant" surrenalic cancer in a young woman affected by chronic hepatitis B related, submitted to "en bloc" surgical resection, locoregional lumphectomy and omolateral nefropexy. The adjuvant post-operative therapy consisted in six cicles of chemioterapy with Mitotane (op'DDD) at conventional dose. Postoperative course was unevenful and the patient was discharged after four days. Postoperative adjuvant therapy was well tolerated and after one year the patient is disease free. In Italy adrenocortical cancer represents about the 10% of adrenal neoplasms and causes a mortality--cancer related--about of 0.1% among all cancers. The incidence of relapse is about 25% after "en bloc" resection with 5 years survival of 54% in stage I-II, 21.4% in stage III, 6.5% in stage IV, respectively. The age < 40 years a functional activity of the mass, stage and resecability of neoplasm represent the most important prognostic factors. The use of mitotane in the postoperative adjuvant therapy is still controversry with variable results. Surgery represents the treatment of choice in case of primary adrenocortical cancer and is well indicated also for patients with advanced stage and recurrent loco-regional disease.

Adrenal Cortex Neoplasms↗