[Soupault-Couinaud intrahepatic biliodigestive anastomosis: an effective palliative treatment of liver hilus tumors].
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Biomedical subjects
Publications and source records attributed to P Perego.
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The perception of life events of Italian and English subjects was compared. Psychiatric patients and relatives rated 58 life events according to the degree to which the event was regarded as upsetting. The similarity between the two groups was noted, although Italian subjects tended to rate events as less upsetting than the English. The findings excluded that the rating differences between the two groups reflected differences in reaction to life and confirmed the existence of scaling similarity over national groups.
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A comparative inquiry has been performed on 57 cases of colonic resections for colon carcinoma carried out in emergency with intestinal anastomoses which have been performed according to Gambee's technique (single layer little introflecting suture), Nockemann's technique (a continuous suture in dexon comprising mucosal and submucosal layers and a separate no introflecting stitch suture of the serosal and mucosal layers in teflene) and 'Auf Stoss'-technique (single layered end-on, no introflecting, no mucosal comprising). We have noticed leakages in 20% of the cases performed with the first method, 13% with the second and 12% with the third method. Here below shown the reasons, why the second and the third method are to be considered the best ones and the indications relevant to their usage. Also are discussed: intraoperative irrigation of the colon according to Dudley and the own technique, short term chemotherapeutic prophylaxis, transanastomotic drain, fibrin glue on colon anastomosis.
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The TSH, T4 and T3 responses to TRH were measured in 48 patients who underwent selective goitre resection (hemithyroidectomy, ablation of single nodule); moreover 3 groups of healthy, hypothyroid and hyperthyroid persons served as reference groups. The main object was to detect eventual onset of preclinical hypothyroidism. This condition was observed after hemithyroidectomy only in 12.5%, and never after ablation of single nodule. Were detected too, among operated patients, 2 subjects with light and 1 with clear hyperthyroidism. Therapeutic implications of such a finding were taken into consideration.
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Two clinical cases of acute gastric dilatation (Cast syndrome) in wearers of surgical corsets for kyphoscoliosis are described. One patient died in spite of surgical treatment, whereas the other responded favourably to conservative management. Fifty cases from the literature are examined. The seriousness and rapid progression of the syndrome are clear from its persistently high mortality (22%). Treatment was conservative in 70% of cases: antishock therapy, nasogastric aspiration, removal of the cast, while duodenojejunostomy was performed in the other 30%. In the two cases described, the seriousness of gastric distress due to compression of the duodenum by the aorta and mesentery was furthered evident from the observation of interstitial gastric emphysema.
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The development of drug resistance is a major obstacle to effectiveness of chemotherapeutic treatment of human tumors with cytotoxic agents. Drug resistance is described as a multifactorial phenomenon, involving the expression of defense factors and/or detoxification mechanisms, alterations in drug-target interactions, and cellular response to specific cytotoxic lesions (in particular, DNA damage). Although the proposed mechanisms may contribute to the development of a variable degree of cellular resistance, it is possible that the cell response (i.e., DNA repair or apoptosis) following DNA damage plays a critical role in determining cellular chemosensitivity. The preclinical observations that tumor response to effective drug treatments is associated with induction of apoptosis support the possibility that a decreased susceptibility to apoptosis (apoptosis resistance) is relevant to clinical resistance. A number of molecular alterations associated with transformation and/or tumor progression may also be implicated in regulation of cell death pathways and in the development of drug resistance. There is evidence that the wild-type p53 is involved in cellular response to DNA damage, including cell cycle regulation, DNA repair, and activation of the pathway leading to apoptosis. Loss of wild-type p53 function could cause resistance to DNA-damaging agents, as a consequence of abrogation of p53-dependent apoptosis. The identification of new agents able to trigger p53-independent apoptosis and the search for biochemical modulators downstream of p53 may be of clinical relevance because many tumors are deficient in p53 function due to mutation or deletion. An overview of the resistance mechanisms is presented, with particular reference to the role of p53 mutations in clinical resistance and of apoptosis-related genes in cellular chemosensitivity.
Primary angiosarcoma of the breast is a rare tumor, with approximately 170 cases reported in the literature (1-3, 10, 11, 15). Reports on the imaging characteristics of these tumors have been occasional until a recent review by Liberman et al. (11). Diagnostic imaging of the masses include mammographic and ultrasound examinations (5): the imaging characteristics of the tumor can be nonspecific and sometimes heterogeneous (11). Only recently was one case evaluated with magnetic resonance imaging (11). We present the mammographic and sonographic features of a case of primary angiosarcoma of the breast with an inflammatory appearance.
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