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Biomedical subjects

M Ferri

Publications and source records attributed to M Ferri.

At least 73 records · Page 4Linked to original sources
PubMed1995

Resection of the suprarenal inferior vena cava. The role of prosthetic replacement.

OBJECTIVE: To review the role of prosthetic replacement after resection of the suprarenal portion of the inferior vena cava (IVC). DESIGN: Retrospective review of a series of six patients with malignant infiltration of the suprarenal IVC undergoing operation in the last 11 years. SETTING: Multispecialty referral center. PATIENTS: One primary leiomyosarcoma and five involvements of the IVC by liver carcinoma (n = 2), adrenal carcinoma (n = 2), and recurrent renal carcinoma (n = 1). INTERVENTIONS: En bloc resection of the tumor with the IVC under total vascular exclusion of the liver in four cases, combined major liver resection in four cases, venous resection including the renal confluence in four cases, prosthetic venous replacement in four cases, and no venous replacement in two cases. MAIN OUTCOME MEASURES: Mortality, venous patency, clinical assessment, and malignant recurrence. RESULTS: One postoperative death (renal failure) following extended resection with right nephrectomy and ligature of the left renal vein. Graft patency was controlled in survivors, with good functional result. Among two patients without venous replacement, one with complete caval obstruction and marked collateral circulation has had a good result, and one with partial caval obstruction experienced transient symptoms of venous insufficiency. Malignant recurrence led to death in four patients (4, 6, 37, and 42 months after surgery). CONCLUSIONS: Suprarenal IVC reconstruction is justified in selected cases, with good functional results. When the renal confluence is resected along with the IVC, renal vein reconstruction may be needed to avoid acute renal failure. The oncologic results of such extensive resections are poor. Adjuvant therapy should be evaluated.

Adult↗
PubMed1995

Myocardial dysfunction and abnormal left ventricular exercise response in autonomic diabetic patients.

In diabetic patients, the pathophysiologic mechanisms of exercise-induced left ventricular (LV) dysfunction remain controversial. In this study, the role of myocardial contractility recruitment in determining an abnormal LV response to isometric or dynamic exercise has been investigated in 14 diabetic patients with autonomic dysfunction. Ischemic heart disease was excluded by the absence of LV wall motion abnormalities induced by isotonic and isometric exercise and by coronary angiography. Left ventricular and myocardial function were studied at rest, and during isometric and isotonic exercise, by two-dimensional echocardiography; moreover, recruitment of an inotropic reserve was assessed by postextrasystolic potentiation at rest and at peak handgrip. An abnormal response of LV ejection fraction to isometric (9/14) or to dynamic (8/14) exercise was frequent in study patients. In these patients, baseline myocardial contractility was normal, and the significant increase in ejection fraction by postextrasystolic potentiation indicated a normal contractile reserve (65 +/- 7% vs. 74 +/- 6%, p = 0.001). Nevertheless, the downward displacement of LV ejection fraction-systolic wall stress relationships during exercise suggests an inadequate increase in myocardial contractility. However, the abnormal ejection fraction at peak handgrip was completely reversed by postextrasystolic potentiation (67 +/- 6% vs. 58.1 +/- 10%, p = 0.008), a potent inotropic stimulation independent of the integrity of adrenergic cardiac receptors. A defective inotropic recruitment, despite the presence of a normal LV contractile reserve, plays an important role in deexercise LV dysfunction in diabetic patients with autonomic neuropathy.

Adult↗
PubMed1994

Results of curative gastrectomy for carcinoma.

BACKGROUND: In the western literature, controversy exists regarding the operative management of carcinoma of the stomach. Still debated are the extent of gastric resection, the role of splenectomy, and the significance of lymphadenectomy. STUDY DESIGN: We performed a retrospective study of 646 consecutive patients who underwent curative gastrectomy for carcinoma of the stomach from 1950 to 1989. A multivariate analysis of nine clinicopathologic and treatment-related variables, including type of gastrectomy, splenectomy, and extent of lymphadenectomy was done to assess the relative influence of these variables on survival. RESULTS: The following variables emerged as independent predictors of death: serosal involvement, distant lymph node metastases, and total gastrectomy. Splenectomy and lymphadenectomy were not related to prognosis. However, a separate analysis on defined subsets of patients revealed that radical lymphadenectomy (removal of N2 nodes) provided a survival benefit in patients with T1-2 N0-1 disease. CONCLUSIONS: These findings suggest that although prognosis of carcinoma of the stomach is mainly determined by the stage of disease at time of operation, the choice of the surgeon can affect survival. Total gastrectomy should be avoided when it is not necessary for proximal tumor location. Subtotal gastrectomy in distally located tumors seems to be the best option. Radical lymph node dissection should be performed when nodal involvement is expected to be limited or absent.

Adult↗
PubMed1993

Use of an Exotic Carbon Source To Selectively Increase Metabolic Activity and Growth of Pseudomonas putida in Soil.

Respiration and growth of Pseudomonas putida PpG7, containing catabolic plasmid NAH7, was determined in three agricultural field soils amended with the carbon source salicylate. The addition of salicylate to soil significantly increased the population of PpG7. However, there was a lack of relationship between microbial numbers and activity as determined by evolution of CO(2). In soils containing 30 to 1,500 mug of salicylate per g, metabolic activities of PpG7 peaked between 18 and 42 h and population densities increased approximately 10-to 10-fold. However, the metabolic activity of PpG7 rapidly declined after salicylate was utilized, whereas peak population densities were maintained for the duration of the experiments (5 to 7 days). Thus, elevated population densities of PpG7 were represented by inactive cells. Soil type had only minor effects on respiration rates or growth curves of PpG7 when amended with comparable concentrations of salicylate. Respiration and growth rates were optimal at concentrations between 300 and 1,000 mug of salicylate per g in the test soils. At 1,500 to 2,500 mug/g, respiration and growth of PpG7 were initially suppressed, but after a short lag time both attained levels similar to or greater than those resulting from the use of lower concentrations of salicylate. The culturing of PpG7 on a salicylate-amended medium to induce salicylate-degradative enzymes did not affect the lag time before utilization of salicylate in soil. Although PpG7 competed well with fungi for the substrate, suppression of fungal populations with cycloheximide resulted in significantly increased population densities of PpG7 in two of three soils amended with salicylate. The beneficial activities of bacteria in soil are discussed in relation to population density, population metabolic activity, and selective carbon source utilization.

Journal Article↗
PubMed1993

Enhanced growth and activity of a biocontrol bacterium genetically engineered to utilize salicylate.

Plasmid NAH7 was transferred from Pseudomonas putida PpG7 to P. putida R20 [R20(NAH7)], an antagonist of Pythium ultimum. The plasmid did not affect growth or survival of R20(NAH7) and was stably maintained under nonselective conditions in broth and soil and on sugar beet seeds. Plasmid NAH7 conferred to R20(NAH7) the ability to utilize salicylate in culture, agricultural field soil, and on sugar beet seeds. The metabolic activity of R20(NAH7), but not the wild-type R20, was greatly increased in soil by amendment with salicylate (250 mug/g) as measured by induced respiration. Population densities of R20(NAH7) were also enhanced in salicylate-amended soil, increasing from approximately 1 x 10 CFU/g to approximately 3 x 10 CFU/g after 35 h of incubation. In contrast, population densities of R20(NAH7) in nonamended soil were approximately 3 x 10 CFU/g of soil after 35 h of incubation. The concentration of salicylate in soil affected the rate and extent of population increase by R20(NAH7). At 50 to 250 mug of salicylate per g of soil, population densities of R20(NAH7) increased to approximately 10 CFU/g of soil by 48 h of incubation, with the fastest increase at 100 mug/g. A lag phase of approximately 24 h occurred before the population density increased in the presence of salicylate at 500 mug/g; at 1,000 mug/g, population densities of R20(NAH7) declined over the time period of the experiment. Population densities of R20(NAH7) on sugar beet seeds in soils amended with 100 mug of salicylate per g were not increased while ample carbon was present in the spermosphere. However, after carbon from the seed had been utilized, population densities of R20(NAH7) decreased significantly less (P = 0.005) on sugar beet seeds in soil amended with salicylate than in nonamended soil.

Journal Article↗
PubMed1993

Relationship between Candida albicans and denture stomatitis: a clinical and microbiological study.

A study was done on 52 upper denture wearers, randomly selected among the residents of two nursing-homes. The results show that the prevalence of Candida albicans in the denture is significantly higher than that in the mucosa. It was also possible to establish a significant relationship between the clinical patterns and the microbiological findings. A healthy mucosa does not present C. albicans, whereas a diffuse denture stomatitis more often presents the yeast both in the mucosa and in the denture. Finally, diffuse erythema is correlated to continuous denture-wearing, while there is not significant correlation between healthy mucosa and type I denture stomatitis and denture-wearing habits.

Candidiasis, Oral↗
PubMed1992

gamma-Hydroxybutyric acid in the treatment of alcohol dependence: a double-blind study.

The effect of gamma-hydroxybutyric acid on alcohol consumption and alcohol craving in alcoholics was investigated in a randomized double-blind study versus placebo. Patients were treated as outpatients during a three month period either with gamma-hydroxybutyric acid (50 mg/kg/day, divided into three daily doses) or with placebo. Of the 82 alcoholics that entered the study, 71 completed it, 36 in the gamma-hydroxybutyric acid and 35 in the placebo group. Alcohol consumption was assessed by the subject's self report. At the 3rd month of treatment, 11 patients in the gamma-hydroxybutyric acid group referred to be abstinent and 15 referred controlled drinking; while in the placebo group only two and six patients referred abstinence and controlled drinking, respectively. Serum-gammaglutamyl-transferase activity correlated with the admitted alcohol consumption. Gamma-hydroxybutyric acid treatment decreased alcohol craving during the 3 months of treatment. Transient side effects were noted by six patients on gamma-hydroxybutyric acid and two on placebo. The results suggest that gamma-hydroxybutyric acid may be useful in the treatment of alcohol dependence.

Adult↗
PubMed1992

Surgical treatment of adenocarcinoma of the cardia.

BACKGROUND: Adenocarcinoma of the gastric cardia presents different features from other gastric carcinomas. This study was performed to analyze the results of a 40-year experience with these lesions. METHODS: Of the 365 patients reviewed, 211 (57.8%) underwent resection. One hundred fifty patients underwent total gastrectomy with lower esophageal resection (TGER) and 46 underwent proximal gastrectomy with distal esophageal resection (PGER). More recently, 15 patients were submitted to total gastrectomy with subtotal esophagectomy (TGSE) without thoracotomy. RESULTS: The tumors were far advanced in most patients: extraparietal invasion in 77.7% of patients, lymph node involvement in 55%, and distant metastases in 11%. The postoperative mortality rate was 25.1% in patients who underwent resection: 26.7% after TGER, 17.4% after PGER, and 33.3% after TGSE (difference not significant). Cardiovascular and respiratory complications were common causes of death after both TGER and PGER. After TGSE, deaths were related exclusively to local complications, mainly as a result of cervical anastomotic leaks. The actuarial 5-year survival rate for all patients surviving resection was 16.7%. No improvement in the results of surgical therapy was observed during the past 20 years. The actuarial 5-year survival rate was significantly affected by pathologic staging: 61.0% stage I, 23.3% stage II, 9.8% stage III, and 0% stage IV (p less than 0.001). No significant differences in actuarial 5-year survival rates were observed between TGER (17.8%) and PGER (14.9%). Sex, duration of symptoms, and histologic type did not reveal prognostic significance. CONCLUSIONS: In early tumors a total gastrectomy with resection of 10 cm of esophagus above the tumor is advocated.

Adenocarcinoma↗
PubMed1991

[Surgery by exeresis for gastric carcinoma. An analysis of 165 consecutive cases].

Surgery is still considered the best approach in gastric cancer. The aim of this study was to identify the most important factors involved in the determination of long-term survival. Total and subtotal gastrectomy were analysed. Long-term survival in these patients was strictly correlated with the stage of disease and the infiltration of resection margins. Early diagnosis is confirmed to be the most important factor in the long-term survival of these patients.

Carcinoma↗
PubMed1990

[Prognostic factors in stomach cancer: invasion of gastric serosa and lymph node involvement].

Concerning prognostic factors in gastric cancer, the Authors analyse the main two influencing long-term prognosis: the depth of penetration of the tumor in the gastric wall and the presence of lymph node metastasis. 194 operated gastric neoplasms were staged, according to TNM classification (U.I.C.C., 1987) and divided into 4 groups: in the first group both the serosa and the lymph nodes were tumor-free; in the second both were involved; in the third only lymph nodes were involved; in the fourth only the serosa was involved. Crossed statistic analysis between groups showed that the only factor that influenced the long-term survival is the node involvement in the patients with tumor-free gastric serosa. These results correspond to most of the others in literature, and point to the connection between these two factors in defining the stage of the disease.

Female↗
PubMed1990

Flow cytometric analysis in colorectal carcinoma: prognostic significance of cellular DNA content.

The prognostic value of DNA ploidy status was evaluated prospectively in 70 patients with colorectal carcinoma. Cellular DNA content was measured by flow cytometry from fresh specimens with multiple site sampling. Seventy-five percent of cases exhibited a DNA aneuploid pattern. In a univariate analysis, DNA ploidy status showed a statistically significant correlation with survival (p less than 0.05), weaker than Dukes' stage (p less than 0.001). No correlation was observed between survival and presence of multiple DNA stemlines. In a multivariate analysis, Dukes' stage was the strongest prognostic indicator (p = 0.01) while DNA ploidy status did not show an independent prognostic value. It is concluded that DNA ploidy status is associated with pathological features of aggressive malignancy, but it does not have a determinant role in predicting survival.

Adenocarcinoma↗
PubMed1990

[Spontaneous pneumothorax. A follow-up of 100 patients].

A total of 135 spontaneous pneumothorax (PNX) episodes, occurring in a sample of 100 patients, are examined with a mean follow-up of 4 years. Aim of this retrospective analysis is to evaluate the influence of different therapeutic approaches on relapse rate. The evaluated treatment options are: respiratory physiotherapy, thoracentesis, prolonged drainage, surgery such as bullectomy or "frottage". By mean of correlation index, a decreased incidence of relapse is shown for surgery--with no relapse--followed by prolonged drainage and then by thoracentesis, and by respiratory physiotherapy.

Adult↗
PubMed1989

[Autotransfusion in elective surgery. Preliminary report on 215 cases].

Two-hundred and fifteen number of patients are presented, who underwent surgical procedures with the support of autologous blood transfusions. The latter have many advantages over traditional allogenic transfusions, such as diminished risk of infections, absence of blood compatibility problems and deep venous thrombosis prophylaxis, through a preoperative controlled state of hemodilution. We have opted for a pre-operative technique, with harvest of blood, obtained before surgery, at quantity of 350 ml each 4 to 5 days. No early, nor late complications occurred, nor any postoperative hemoglobin or hematocrit decrease. The above data, together with a relevant reduction of cost per blood unit, to encourage a wide use of autologous blood transfusion, whenever feasible.

Adult↗
PubMed1989

[Adenocarcinoma of Meckel's diverticulum].

A case of adenocarcinoma of Meckel's diverticulum is reported. Small bowel neoplasias are the least frequent in the gastrointestinal tract and localization to the diverticulum is extremely rare. Among histological types, adenocarcinoma accounts for the minority of cases. Early diagnosis is difficult because of lack of specificity of signs and symptoms, except in advanced stages. Small bowel resection with lymphadenectomy is the recommended therapeutic approach. Although, in reported case it could not be performed, because of the diffuse intraabdominal metastasis at diagnosis. This and similar cases would open the discussion about a possible indication for prophylactic resection of Meckel's diverticulum. No definitive conclusion can be drawn at present since no follow-up study is available on the natural history of diverticula which have been observed during abdominal surgery and have not been resected.

Adenocarcinoma↗
PubMed1989

Gamma-hydroxybutyric acid for treatment of alcohol withdrawal syndrome.

The effect of gamma-hydroxybutyric acid (GHB) on ethanol withdrawal syndrome in alcoholics was investigated in a randomised double-blind study. Patients with withdrawal symptoms were treated either with GHB (orally in a syrup preparation) (11 patients) or with the syrup alone (12). GHB treatment (50 mg/kg) led to a prompt reduction in withdrawal symptoms, such as tremors, sweating, nausea, depression, anxiety, and restlessness. The only side-effect was dizziness. GHB may be useful in the management of alcohol withdrawal syndrome in man.

Administration, Oral↗
PubMed1989

[Afferent loop syndrome as an epiphenomenon of neoplasms of the gastric stump].

A clinical case is the basis for a report on the possibility that afferent loop syndrome might present as an epiphenomenon in gastric stump cancer. Stress is laid above all on the rarity of the syndrome and on the clinical and diagnostic difficulties of demonstrating it. The possibility that it might be a pointer to a pathology of greater clinical importance is pointed out.

Adenocarcinoma↗
PubMed1989

[Aneurysm of the innominate artery: pathology simulating pulmonary neoplasm].

A chance case of aneurysm of the brachiocephalic trunk suggested a review of the literature on this rare pathology. Stress is laid on the possible asymptomaticity of the lesion and on its frequent chance observation in chest X-rays; the diagnostic procedure, at times particularly complex, may not lead to decisive results but the possibility of aneurysm of the brachiocephalic trunk must be borne in mind in any case so as to avoid gross diagnostic and therapeutic errors.

Aged↗