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Biomedical subjects

M Morino

Publications and source records attributed to M Morino.

At least 73 records · Page 4Linked to original sources
PubMed1994

Transanal endoscopic microsurgery in Italy.

The Italian experience with Transanal Endoscopic Microsurgery (TEM) started in 1991. Until April, 1994, 122 patients were operated on by such a technique in six centres. The surgical protocol in the 66 patients with benign lesions was similar to that described by Buess. In contrast to the German experience, the indications of TEM for cancer have been extended to more advanced tumours and in 22 out of 56 patients with rectal carcinoma adjuvant radiation- or radiation-chemotherapy have been applied according to various protocols. In 88% of TEM for rectal tumours the operation has been carried out according to a full-thickness technique, with or without perirectal fat excision. Postoperative morbidity of TEM for adenoma was 15.8% and that of TEM for carcinoma 29.6%. There was no postoperative mortality. Local recurrence rate after TEM for adenoma was 10.5%, while that after TEM for cancer was 9.25%. No local recurrence has been reported among patients treated with a combination of TEM and adjuvant radiation treatments. The median follow-up in the 6 centres ranged between 7 and 16 months. A randomised prospective clinical trial has been planned in order to evaluate the role of transanal endoscopic microsurgery in the treatment of locally advanced rectal cancer.

Adenocarcinoma↗
PubMed1993

Preoperative chemoembolization for hepatocellular carcinoma.

In a group of 396 patients who had chemoembolization for hepatocellular carcinoma (HCC) between 1984 and 1991, 67 underwent surgery (segmentary/subsegmentary resections: 31; or transplantation: 36). Morbidity was limited to hepatic insufficiency (seven), arterial thrombosis (two), vasculitis (five), cholecystitis (two), and hepatic abscess (one). Perioperative mortality was 5.5% for transplantation and 6.7% for resection. Histological examination of resected specimens showed a total or subtotal tumor necrosis in 58% of the cases, and a necrosis between 50% and 80% in another 18%. Data on recurrence and long-term survival are not significant if retrospectively compared with non-chemoembolized surgically treated patients. Chemoembolization is known to be an effective palliative treatment of HCC. Its role in the preoperative setting is sustained by a 58% of total or subtotal histological necrosis. A multicentric prospective trial to evaluate the role of preoperative chemoembolization for long-term survival and recurrence of HCC is advocated.

Adolescent↗
PubMed1992

Effect of extended cold ischaemia with UW solution on graft function after liver transplantation.

Studies in animals on the use of UW solution in liver transplantation have shown an inverse relation between cold ischaemia time (CIT) and graft function. There are few clinical data on this relation in human beings. We have investigated the effect of extended cold ischaemia in a prospective study. We assessed early graft function and subsequent outcome for 306 consecutive elective liver transplantations; for analyses, grafts were grouped according to CIT (< 12 h group A, > or = 12 h group B), since a preliminary study identified 12 h as a significant cut-off point. Initial graft function was better in group A than group B, as shown by maximum alanine aminotransferase activity (mean 623 [805] vs 946 [1148], p = 0.02), bile production on days 1-3 (p < 0.05), maximum serum bilirubin by day 10 (206 [166] vs 244 [163] mumol/l, p = 0.04), and frequencies of primary non-function (1 [0.4%] vs 4 [7%], p = 0.006) and hepatocyte necrosis on routine biopsy sample after reperfusion (18% vs 31%, p = 0.04). Long-term outcome was also better in group A than group B; graft and patient survival rates were higher and fewer retransplantations were needed. These findings suggest that cold ischaemia in UW solution for longer than 12 h is a risk factor for graft function and patient survival. We recommend that the limit of the safe CIT be reconsidered.

Adenosine↗
PubMed1992

Extracorporeal shock wave lithotripsy and xanthine calculi in Lesch-Nyhan syndrome.

We report a case of Lesch-Nyhan syndrome (LNS) with urinary xanthine calculi. At eight years of age calculi in the renal pelvis were successfully disintegrated by extracorporeal shock wave lithotripsy (ESWL) without any complications. Follow-up sonography is very useful for management of patients with LNS, particularly when they are on allopurinol therapy.

Allopurinol↗
PubMed1992

Primary treatment of hepatocellular carcinoma by arterial chemoembolization.

Two hundred and ninety-one patients with hepatocellular carcinoma were treated by chemoembolization (CE), using ethiodized oil, doxorubicin, and a gelatin sponge. Patients with thrombosis of either the portal vein or a main branch were excluded. The mortality rate in the first 2 months after treatment was 7% in noncirrhotic patients, 2.8% in patients with class A cirrhosis, 8% in patients with class B cirrhosis, and 37% in patients with class C cirrhosis. The tumor diameter remained the same in 55.3% of patients, was reduced by up to 50% in 20% of the patients, was reduced by more than 50% in 7.3% of the patients, and almost completely disappeared in 1.8% of the patients. The diameter of the tumor increased in 15.6% of patients. Forty-three patients underwent a resection or transplantation after chemoembolization. Histologic examination of the specimens revealed significant necrosis of the tumor. The long-term survival rate at 2 years was 49% for class A cirrhotics, 29% for class B cirrhotics, and 9% for class C cirrhotics. Complications included cholecystitis (10%), vasculitis (14%), renal decompensation (13%), an increase in ascites (14%), and jaundice (12%). Chemoembolization is an effective and safe initial treatment for hepatocellular carcinoma. It is effective in producing tumor necrosis and reducing the size of the tumor. Improvement in survival was noted when patients who underwent chemoembolization were compared with an historical series of untreated patients, and resection and transplantation are kept as options.

Adolescent↗
PubMed1992

Effect of storage temperature on early graft function following liver transplantation.

The effect of storage temperature on early graft function following liver transplantation was investigated by analyzing the results following transplantation during three periods in which different techniques for graft storage were used. The techniques involved ice-packing (period 1), storage in a standard operating room refrigerator without ice-packing (period 2) and storage in an accurately controlled refrigerator without ice-packing (period 3). In period 2 there was a significantly higher incidence of histological lesions, primary non-function and retransplantation compared to periods 1 and 3. It was concluded that this was due to inaccurate control of the standard refrigerator in period 2, thus allowing the temperature of the graft to increase, while in periods 1 and 3 the graft temperature was kept close to 4 degrees C by ice-packing and accurate refrigerator control, respectively. These results demonstrate that accurate control of storage temperature is important in terms of subsequent graft function. This may become more important as storage times are progressively increased with the use of UW solution.

Cold Temperature↗
PubMed1992

[Synchronous and metachronous carcinomas of the large intestine].

The authors present their experience relative to 5 patients with multiple carcinomas (synchronous and metachronous) of the large bowel. They underline that full examination of the colon before operation in all patients with primary colorectal cancer is necessary, and they propose a lifelong follow-up program after resection for early detection of multiple carcinomas.

Carcinoma↗
PubMed1991

Acute tubulointerstitial nephritis in two siblings and concomitant uveitis in one.

Two sisters with acute tubulointerstitial nephritis (ATIN) are reported. The elder sister had concomitant uveitis which recurred twice. The younger sister became ill five years after the onset in the elder. Both patients had identical HLA haplotypes and also suffered from mild chronic sialoadenitis. A renal biopsy specimen of the elder sister showed not only marked interstitial infiltration of immunoglobulin-containing mononuclear cells but also immunecomplex-related glomerulonephritis. The younger sister had immune complexes in the serum. These findings suggest that glomerulonephritis and uveitis may be secondary phenomena of ATIN with participation of circulating immune complexes. Once the uveal involvement has occurred, uveitis may undergo relapses without any renal manifestations.

Acute Disease↗
PubMed1990

[Current approach in the treatment of Zollinger-Ellison syndrome].

On the basis of six surgically operated patients, current thinking with regard to the treatment of Zollinger-Ellison syndrome is outlined. Total gastrectomy which for many years was the most common surgical intervention, is now confined to just a very specially indicated few cases because the introduction of anti-H2 gives good control of gastric secretion. The operation should therefore be targeted at removing the gastrinoma, helped in this by modern methodologies for pinpointing the neoplasia. Long-term however include a certain number of failures.

Humans↗
PubMed1989

[Evaluation of the spread of cancer of the exocrine pancreas and biliary tract].

The assessment of pancreatic and biliary tract carcinoma extension obviously depends on the possibilities of treatment. Resection being the only treatment of these malignancies, the assessment must be conducted in such a way as to search for its contra-indications, and it will deal successively with the patient's operability, the distal extension of the tumour (thoracic CT scan, Abdominal CT scan, ultrasonography of the liver and abdomen) and its local and regional extension (ultrasonography of the liver and pancreas, transparietal transhepatic cholangiography, angiography). If these examinations show no formal contra-indication to surgery, then exploratory laparotomy will be performed to determine whether the operation is technically feasible and whether it should consist of resection or palliative bypass.

Biliary Tract Neoplasms↗