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Biomedical subjects

M Milella

Publications and source records attributed to M Milella.

At least 73 records · Page 4Linked to original sources
PubMed1990

Hepatitis B virus clearance from serum and liver after acute hepatitis delta virus superinfection in chronic HBsAg carriers.

Clinical, virological, and histological findings in four HBsAg chronic carriers who cleared HBV markers from both serum and liver following HDV superinfection are described. The patients were long-term HBsAg carriers and all were HBV-DNA/HBeAg positive. Liver biopsy, obtained from three of the patients between 5 and 15 months prior to HDV superinfection, showed chronic persistent hepatitis in two and chronic active hepatitis in one. During the follow-up of 9-19 months, the patients completely recovered from acute delta hepatitis with termination of HBsAg carriage and regression of the histological feature of chronic liver damage. These data demonstrate that sometimes HDV is able to induce a permanent inhibition of its helper virus. HDV superinfection probably enhances the immune clearance of infected cells during the replicative phase of chronic HBV infection.

Acute Disease↗
PubMed1988

Effects of HIV superinfection on HBV replication in a chronic HBsAg carrier with liver disease.

A case of HIV superinfection observed in an HBsAg/HBeAg-positive male homosexual with chronic persistent hepatitis is described. Soon after the appearance of clinical and serological features of acute HIV infection, a rapid fall to a normal value of ALT was noted with simultaneous recrudescence of HBV replication lasting for several months as detected by an increase of the HBV-DNA concentration in the serum. Our observations suggest that the reduction of hepatocyte necrosis and the increase in HBV replication were a consequence of impaired T cell function during acute HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Permanent inhibition of viral replication induced by low dosage of human leukocyte interferon in patients with chronic hepatitis B.

Fourteen out of 28 HBsAg/HBeAg-positive carriers with chronic persistent and active hepatitis were randomly assigned to human leukocyte interferon (a-IFN) treatment for three months. The remaining 14 patients served as controls. Each treated subject received a standard i.m. dose of 0.7-1.0 X 10(5)/kg/day reference units of a-IFN for 28 consecutive days, and then the same dose twice a week for two months. This treatment regimen was well tolerated, and no remarkable side effects were recorded. At six months the number of patients who permanently lost HBV-DNA from serum was significantly higher in the treated group (p = 0.006) than in the untreated group. These results suggest that a less expensive and well tolerated treatment regimen based on low dosage of a-IFN may be as effective in producing permanent inhibition of hepatitis B virus replication as a treatment regimen based on larger dosage.

Adult↗
PubMed1987

Spontaneous massive necrosis of a hepatocellular carcinoma.

A case of hepatocellular carcinoma that underwent total necrosis without previous chemotherapy is described. Histologic examination of the neoplasm revealed massive thrombosis of numerous peritumoral venous vessels in the adjacent normal liver. Although the importance of a newly formed arterial blood supply for the maintenance of the viability of hepatocellular carcinoma is unquestionable, this case suggests a similar importance of the venous drainage of the surrounding liver.

Aged↗
PubMed1985

[Multidisciplinary radiological diagnosis of hepatic angioma in cancer patients].

72 cases of hepatic angioma were examined. These were occasionally found during control investigations of patients treated for extrahepatic primary cancer, or revealed by ultrasound studies of patients not supposed to be affected by cancer. Prospective comparison in 18 cases was made between echotomographic, tomodensitometric and angiographic findings with purpose of pointing out possible correlations between the X-ray images and the anatomopathological pictures. Finally, the best diagnostic procedure was established for suspected hepatic angioma, in both a cancerous and a non cancerous patients.

Angiography↗
PubMed1984

[Action of indoprofen on atrio-ventricular conduction. Preliminary note].

The purpose of the present study was to evaluate the possible electrophysiological effects of Indoprophene, a new non steroidal analgesic anti-inflammatory agent, which might be employed in the treatment of chest-pain from myocardial ischemia. Ten patient, who were undergoing a electrophysiological study for diagnostic purposes, were given 400 mg of indoprophene by intravenous rapid bolus. The A-V conduction times were recorded in basic condition and 30 minutes after administration of the drug. The data we collected show that Indoprophene does not influences either normal or prolonged A-V conduction times. We conclude that the drug, as it has a good effect on pain and lacks haemodynamic consequences and effects on conduction and excitability, is recommendable for the treatment of chest-pain from myocardial ischemia.

Aged↗
PubMed1984

Massive lymphorrhoea after fine needle biopsy of the cystic haemolymphangioma of the liver.

Trauma to a hepatic haemangioma from a fine needle biopsy has not yet been reported and the theoretical high risk with 22-23 g needles in patients with this lesion tends to be minimised. Through misdiagnosis biopsy was ordered in one case of cystic haemolymphangioma of the liver in a patient being checked by ultrasonography for possible metastases. Aspiration was complicated by a massive peritoneal lymphorrhoea, which regressed completely in 15 days. The mechanics of the event and its possible effect on the pre-existing liver failure, held to be the direct cause of death three months later, is a matter of hypothesis.

Adult↗
PubMed1982

Combined modes of imaging for liver hemangioma in cancer patients.

Twenty-nine consecutive patients with single or multiple liver hemangioma were assessed with more than one mode of imaging. Static scanning with 99Tcm was done in 21, ultrasonography in 28, CT in 29 and angiography in 27. Fine-needle percutaneous biopsy was unwisely performed in 7 cases with a single but singular complication, severe peritoneal lymphorrhea. Four laparotomies and 2 laparoscopies completed the investigations. Fourteen patients had a history of primary cancer, and 3 of these had a secondary coexisting with the angioma. CT was characteristic; ultrasonography was sensitive and perhaps specific enough for small angiomas. The 2 combined plus angio-CT greatly reduce the need for hepatic angiography.

Angiography↗
PubMed1982

[Echography and percutaneous fine needle biopsy].

Echography, even if it is a procedure widely used in numerous protocols, is not devoid of diagnostic inaccuracy. However, when fine needle percutaneous biopsy is associated to echography, the diagnostic accuracy raises to 88%. This combined procedure is easily carried out, it is inexpensive, without discomfort to the patient and devoid of major complications. When it is performed, other more invasive techniques, such as arteriography or laparotomy may be useless. Methods of application and case-reports are illustrated.

Adenocarcinoma↗
PubMed1981

Microsphere angiography in hepatic artery infusion for cancer.

99mTc-human albumin microspheres were injected at a slow rate into the hepatic arteries of 24 patients before starting intraarterial chemotherapy for liver cancer. The distribution patterns of radiolabeled microspheres were significantly different from those obtained in contrast angiography in 13 of 22 patients. Liver uptake of slowly injected microspheres was greater than 75% in 16 of 24 patients and less than 25% in 4 of 24 patients. A significantly increased arterial blood supply to intrahepatic neoplastic regions was demonstrated in 12 of 20 patients. Microsphere examination allowed an easy evaluation of the relative perfusion of the liver and of the intrahepatic distribution of arterial blood flow in all patients.

Angiography↗
PubMed1981

Exploiting gravity in abdominal angiography.

The difference between the specific gravity of blood and contrast medium and the consequent tendency of contrast media to fill the lower tissues is exploited in abdominal angiography by special positioning of patients: prone for the coeliac, hepatic and mesenteric arteries, prone with the legs raised for abdominal aortography; lateral decubitus on the side of interest for renal angiography. The advantages are better parenchymal opacification, increased contrast and improved details. Gravity positioning saves time and material, and is easy to learn.

Angiography↗
PubMed1981

[Fine needle biopsy with ultrasound guidance: 263 cases (author's transl)].

The combination between ecography and fine needle aspiration biopsy has greatly speeded up diagnostic procedures. Often this technique is better than other more invasive and expensive investigations, such as angiography and laparotomy, for its high diagnostic accuracy, the limited upsetting of the patient, the absence of serious complications and the simplicity to perform it. Here are some information on the technique, on the indications and on the complications of the procedure. The results of 263 cases of abdominal biopsy are presented.

Abdominal Neoplasms↗
PubMed1980

Pancreatic tumor imaging by III generation CT, gray-scale ultrasound and improved angiography.

Thanks to computed tomography (CT) and gray-scale ultrasounds the possibilities of morphological diagnosis in pancreatic disease have improved. Nevertheless, only a part of the potential performances of this practice is known and especially for ultrasounds, where only an expert eye can properly read the resulting images. With the help of pictures we hereby deal with the above-mentioned procedures in the demonstration of a pancreatic neoplasm. The possible integration with other more invasive methods was verified compared to pancreatic angiography. The latter is irreplaceable in the presurgical stage, and the method proposed by the authors can be useful when other methods cannot be employed.

Angiography↗
PubMed1980

Improving arteriography of the pancreas.

Simple celiac and mesenteric arteriography in the prone position with the injection of a large bolus of contrast medium, as fast as possible, is evaluated on the available data against the more complex usual procedure for diagnosing diseases of the pancreas. The new procedure, based upon a better distribution of the contrast medium because of its density, can well simplify angiography of the pancreas without a loss of information.

Angiography↗
PubMedDate not supplied

Detection of hepatitis B virus DNA in serum by spot hybridization technique: sensitivity and specificity of radiolabeled and biotin-labeled probes.

The detection of serum hepatitis B virus (HBV) DNA in 32 chronic HBsAg carriers was performed by spot hybridization technique using both biotinylated and radiolabeled probes, in order to compare their specificity and sensitivity. Our results show that both assays are specific since neither evidence of cross-hybridization between HBV DNA and sera from patients with chronic non-A, non-B (NANB) hepatitis was found, nor HBV DNA was detected both in patients with chronic anti-HBs/anti-HBc-positive hepatitis and in patients negative for all HBV markers. An agreement between the two assays was observed in 94% of the tested sera. Even though in 5 serum samples (6%) low levels of HBV DNA (0.1-1 pg/100 microliter) remained undetected using the biotin-labeled probe, the lower detection limit of the two assays (0.1 pg of HBV DNA) was the same using purified Dane particles as control. This study indicates that the enzymatic detection of HBV DNA is suitable for routine and rapid monitoring of HBV replication in both HBeAg- and anti-HBe-positive patients, as well as for a semiquantitative analysis of serum HBV DNA.

Biotin↗
PubMedDate not supplied

Percutaneous gastrostomy in oncologic patients: analysis of results and expansion of the indications.

BACKGROUND: Percutaneous gastrostomy is generally performed for permanent enteral nutrition or gastric decompression. METHODS: In our series of oncologic patients, percutaneous gastrostomy was also used temporarily in some patients for enteral nutrition while awaiting functional recovery of swallowing, in preparation for surgery, or for the treatment of fistulas in the upper digestive tract. Fifty-one procedures were performed in 50 patients: 42 for feeding, eight for decompression, and one for transgastric drainage of a duodenal fistula. RESULTS: Of the 35 patients treated for permanent enteral nutrition, four are still alive, with a total survival time of 2,167 days. In three patients, gastrostomy was performed for temporary feeding and was removed once the ability to swallow was restored. In four patients, it was created to restore metabolic balance before surgery. In the patient with a duodenal fistula, healing was achieved in 19 days. The seven patients in whom the procedure was performed for decompression survived for a mean of 19.2 days. There was only one major procedure-related complication (peritonitis). CONCLUSIONS: Percutaneous gastrostomy is a safe, low-cost method that allows the patient to maintain essential nutrition without the discomfort of a nasogastic tube and therefore warrants wider and earlier use. We feel that its application should also be extended to temporary feeding of patients about to undergo long courses of chemotherapy and radiotherapy, which can lead to severe deterioration of nutritional status.

Aged↗