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Biomedical subjects

M Stella

Publications and source records attributed to M Stella.

At least 109 records · Page 6Linked to original sources
PubMed1980

A new case of human Y chromosome with satellites on the long arm.

A Y chromosome with satellites at the end of the long arm is reported. The banding techniques RBG, GTC, C and N were used. C-banding revealed a reduction of the heterochromatic part of the chromosome. The pedigree of the family didn't show any pathological feature in the carriers of this morphological variation. The frequency of satellite association was also studied.

Abnormalities, Multiple↗
PubMed1979

Partial trisomy 4q: two cases with a familial translocation t(4;18)(q27;q23).

Clinical and cytogenetic data of two related patients, both trisomic for the segment 4q27 to qter, are reported. Familial studies determined that the mothers of the two probands were carriers of the same balanced translocation between chromosomes 4 and 18. Altogether, two partial trisomies 4q, five balanced karyotypes, and one 45,X0 karyotype were found in the family. The 18 cases reported to date are reviewed with respect to the karyotype-phenotype correlation.

Child↗
PubMed1978

BUdR as a tracer of the possible mutagenic activity of Pb++ in human lymphocyte cultures.

The method of SCE was used as an indicator of the possible mutagenic activity of lead acetate in in vitro cultures of human lymphocytes. After determining the optimal concentration of BUdR, the cultures were treated with increasing doses of the metal. The negative results obtained with this method led us to examine other parameters, in particular the classical cytogenetic aberrations.

Bromodeoxyuridine↗
PubMedDate not supplied

Reducing the occupational risk of infections for the surgeon: multicentric national survey on more than 15,000 surgical procedures.

The objective of this study was to find the incidence of accidental exposures to blood and body fluids among surgeons during operations and to describe their dynamics. A probabilistic model was also used to predict the cumulative 30-year risk to the surgeon of contracting hepatitis B and C viruses (HBV, HCV) or human immunodeficiency virus (HIV) infection and estimate the effect of preventive strategies in reducing this risk. A multicentric prospective survey, based on self-administered questionnaires, was conducted during a period of 6 months in 39 Italian hospitals. As accidental exposure to blood or body fluids occurred in 9.2% of 15,375 operations. In about 2% of procedures a parenteral-type injury, such as actual skin puncture or eye contamination, was suffered by the operating surgeon. A needle-stick injury was the commonest accident, and its occurrence was found to vary with the phase of the procedure and its length. The current lifetime risk of acquiring HBV, HCV, and HIV infection in our regions was estimated to be as high as 42.7%, 34.8%, and 0.54%, respectively. The adoption of preventive strategies is expected to reduce this risk to 21% for HBV, 16.6% for HCV, and 0.23% for HIV infection. Active immunization of surgeons against HBV is strongly recommended. The case is also made for the use of a face-shield combined with a permanent change in our surgical practice capable of reducing the current high rate of parenteral injuries.

General Surgery↗
PubMedDate not supplied

Characterization of T-cell subsets infiltrating post-burn hypertrophic scar tissues.

In this study, skin-infiltrating cells were characterized in both the active and remission phases of post-burn hypertrophic scar biopsies. Immunohistochemistry examination of active phase samples showed an abundant presence of Langerhans cells, T cells, macrophages, a low presence of natural killer cells and the lack of B lymphocytes. In active hypertrophic scars T lymphocytes infiltrate deep into the superficial dermis and are also observed in the epidermis: CD3+ cells were present at about 222 +/- 107 per 0.25 mm2. In particular the analysis of lymphocyte subpopulations showed that CD4+ T cells predominate in the dermis as well as in the epidermis of active hypertrophic scars whereas CD8+ cells were less well represented (CD4/CD8 ratio is 2.06). This distribution was also shown in remission phase samples and in normotrophic scar specimens, although the lymphocyte number was significantly lower. Approximately 70 per cent of T lymphocytes present in the tissue involved in active phase hypertrophic scar samples were activated (positive with anti-HLA-DR and IL-2 receptor antibodies) which is significantly higher than remission phase hypertrophic and normotrophic scars, in which positivity was 40 and 38 per cent, respectively. Upon activation, the lesional lymphocytes release several cytokines, locally and transiently, that interact with specific receptors in response to different stimulation. Central to the immune hypothesis of hypertrophic scars is that some of the T-cell lymphokines act on keratinocytes, fibroblasts and other cell types to induce changes characteristic of these scars. The presence and close proximity of activated T lymphocytes and antigen-presenting cells of various phenotypes in both the epidermis and dermis of hypertrophic tissues provides strong circumstantial evidence of a local immune response. However, the manner in which T cells achieve and maintain their activated state in hypertrophic tissues is not yet known, and both antigen-dependent and independent mechanisms may contribute.

Adolescent↗
PubMedDate not supplied

[Carcinoid of the appendix. A case report].

A case of a young male operated on for acute appendicitis due to a carcinoid of the base is reported. Since the tumor was infiltrating the resection margin of the appendix, the patient was later treated with a right hemicolectomy. Carcinoid tumor is unusual, but can be encountered several times during the career of a surgeon (1/200-300 appendicectomy). The tumor is more frequent in women (2-4:1), located at the tip of the appendix (62-78%) and has a diameter less than 1 cm in 70-95% of cases. It is more frequently diagnosed incidentally after an operation for acute appendicitis and occasionally during other procedures (colectomy, cholecystectomy, salpingectomy). Liver metastases are rare (< 2%), related to the dimension of the primitive tumor (21-100% when > 2 cm) and can cause a "carcinoid syndrome": flush, diarrhea bronchoconstriction, cardiac valve disease. Diagnosis is made by the pathologist and staging by conventional radiologic procedures (TAC, US), dosage of neuroendocrine mediators such as 24 hours urinary 5-HIAA. Nowadays 111In-octreotide scintigraphy (SRS) has an 86% sensitivity to detect the carcinoid and is useful for staging and for planning a surgical intervention. Simple appendectomy is adequate treatment for appendiceal carcinoids less than 1 cm in diameter. Adequate treatment for tumors greater than 2 cm is right hemicolectomy. A point of controversy is what to do for tumors in the 1 to 2 cm range. It seems that appendectomy alone is sufficient except in those cases when mesoappendiceal invasion is identified. When surgical margins after appendectomy are not free of tumor, additional surgery seems warranted. Carcinoid tumor of the appendix has a good prognosis with a 5-year-survival rate, of 85.9-100%. When liver metastases are encountered octreotide can relieve symptoms and sometimes the progression of the disease.

Abdomen↗
PubMedDate not supplied

[Dialytic therapy in severely burnt patients with acute renal failure].

BACKGROUND: Appearance of acute renal failure (ARF) in severely burnt patients (GU) is a serious complication. It has a negative prognostic value and almost always develops in the context of multiple organ dysfunction syndrome (MODS) induced by sepsis. Over the last 20 years, according to data available, the mortality rate has been reported to reach about 75%. We have analyzed the initial results obtained in GU patients who were admitted to the Intensive Care Unit of the Burns Center in Turin. METHODS: Out of 105 GU patients admitted between July 1999 and September 2000 (burned surface area (BSA) 23.8%, range 2-95%, mortality rate 13.7%), 7 patients (6.4%) had complications of ARF requiring extracorporeal dialytic therapy (38 HF sessions lasting 4-6 hours, 2 HF + 12 HDF + 1 UF sessions lasting 8-11 hours). RESULTS: Total BSA of 7 GU patients with ARF was 62.5+/-11.3% (mean +/-SEM). Mortality rate was 71.4% which was due to septic shock and MODS. ARF onset was at 28.4+/-8.4 days from admission. Dialytic treatment started at Crs 2.3+/-0.42 mg/dl, and patients were treated for 7.6+/-3.5 days with a weight loss of 1859+/-161 gr/die. Circuit anticoagulation was obtained by minimal amount of heparin (132.2+/-26.5 U/hour) and no hemorrhagic complications were observed. CONCLUSIONS: In GU patients with ARF the dialytic treatment with daily long-lasting convective- diffusive techniques permitted us to achieve a survival and dialytic adequacy similar to those reported with continuous renal replacement therapies; however, mortality rate is high and related to septic shock and MODS.

Acute Kidney Injury↗
PubMedDate not supplied

[Intraoperative use of radiofrequency thermoablation of liver tumors: considerations on indications and related therapeutic aspects].

PURPOSE: To evaluate the usefulness of intraoperative radiofrequency thermoablation of liver tumours in association or not with hepatic resection. MATERIALS AND METHODS: 21 patients were treated between January 1998 and December 2001, there were 4 hepatocellular carcinoma and 17 metastasis. In 13 cases radiofrequency was associated to hepatectomy, in 3 cases to resection of extraepatic disease and in 5 cases were performed alone. 23 lesions were treated by radiofrequency (range 1-3); the mean dimension was 26 millimetres (range 8-70). A clamping of the liver pedicle was always done. RESULTS: There were no operative deaths, 3 (14.3%) patients developed complications related to radiofrequency (2 biliary leakages, 1 hepatic abscess). 14 (66.7%) patients were alive after a mean follow up of 14.5 months, 2 of all (9.5%) had a recurrence in the site previously treated with thermoablation. Association between hepatectomy and radiofrequency increased the number of curative liver resections from 10.1% to 16.3% (in case of colorectal metastasis). DISCUSSION: Intraoperative radiofrequency is useful to increase the number of curative hepatectomies, to treat liver masses which demonstrate unresectable or found by ultrasonography at the operating time and even to reach tumours difficult to manage by percutaneous approach. In any case the aim is to obtain the absence of macroscopic neoplastic disease (RO status). It is a safe and effective therapeutic strategy, anyway all procedures and indications are still not completely cleared. CONCLUSIONS: Intraoperative thermoablation of liver tumour is safe and effective and increases therapeutic the number of curative hepatectomies. Further progresses may improve the efficacy and extend the indications of this strategy.

Adult↗
PubMedDate not supplied

[Atypical presentation of angiomiolypoma in a patient with peritoneal metastases from ovarian cancer: a case report].

A renal mass with not typical instrumental characteristic in patient in follow-up for ovarian neoplasia sets to the surgeon serious doubts about proper surgical strategy. Achieve of the conservative renal surgery assisted by the intraoperative use of the radiofrequency energy has allowed to preserve the renal function and the diagnosis of unknown angiomyolipoma.

Adenocarcinoma, Papillary↗
PubMedDate not supplied

[Severe renal failure in a child].

A four-year-old male child was admitted with severe renal failure, apparently recent in onset and he was treated with peritoneal dialysis (PD). A renal biopsy showed interstitial cellular infiltration with crystals within the tubules and sclerotic glomeruli. Type I hyperoxaluria was diagnosed and the child received a liver and kidney transplant after 10 months of dialysis. Two years later, he has normal renal function, and blood and urine oxalate levels are within normal ranges.

Biopsy↗
PubMedDate not supplied

Radiofrequency ablation of liver tumours with transpleurodiaphragmatic access.

Radiofrequency thermoablation (RFA) is used to treat unresectable liver tumours. RFA is performed using an abdominal access (laparotomic, laparoscopic and percutaneous). A transpleurodiaphragmatic approach has recently been proposed, particularly for the treatment of tumours which are placed near to inferior vein cava and hepatic veins and which are difficult to reach for an abdominal access. A patient with a liver metastasis of the segment VIII underwent RFA with an associated wedge resection of the segment VII, both were performed with a transthoracic access. Peri- and postoperative complications did not occurred. The patient was discharged on fifth postoperative day, and she is disease free after a follow up of 6 months. A transpleurodiaphragmatic access can be considered a safe and efficacy procedure to perform an RFA of a liver tumour in selected cases.

Catheter Ablation↗
PubMedDate not supplied

Radiofrequency thermal ablation of hepatocellular carcinoma: our five year experience.

PURPOSE: We describe our experience in the multimodal treatment of HCC patients both using the PRFTA and IRFTA treatment associated or not with hepatic resection, valuating the feasibility, the complication, length of hospital stay and survival rate of selected HCC patients. MATERIALS AND METHODS: Between March 1998 and January 2004, 53 HCC patients undergoing PRFTA and IRFTA treatment. We describe 41 patients with monofocal disease and 12 patients with multifocal disease: in this last group 7 patients had unilobar involvement while 5 patients had multilobar tumour. RESULTS: We reported patients underwent RFTA because not candidates to surgical procedures and patients underwent liver resection and open radiofrequency treatment associated. We successfully used percutaneous and intraoperative approach being the last one significantly advantageous in lesions greater than 5 cm, multiple bilobar tumours and tumours close to the hilum and major vessels: the laparotomic approach permitted the temporary occlusion of the vascular inflow allowing Pringle manoeuvre. DISCUSSION: Hepatocarcinoma still represent one of the major causes of cancer related death worldwide. Systemic therapeutic agents and locoregional agents are rarely correlated to complete response and usually associated to high toxicities: the potentially curative or palliative benefit of RFTA in non surgical candidates improve overall patients survival significally better then the chemotherapy regimens. CONCLUSION: RFTA appears to have several advantages, which also include a reducing in morbidity, a shortening of the hospital stay and good response to patients requirement in term of enduring pain.

Carcinoma, Hepatocellular↗