Biomedical subjects
Publications and source records attributed to S Gorgone.
The authors state their experienle about the use of the maemagglutination reahtion test for the diagnosis of human hydatid disease, and point out this is a sensitive and highly specific technique, and, moreover, its execution is rapid and easy.
The authors, after reporting the data concerning the increase of the average length of life and the increment of the population in geriatric age, studied the different aspects of the surgical risk. They consider the age, the existence or absence of associated diseases, the situation of the different organs or apparatuses, and the possibility to correct, in preoperative stage, the different functional unbalances remarked. At last, after confirming the conception whereby age for itself does not represent a specific factor of risk, they emphasize the importance of a multidisciplinary cooperation in the assistance to old patients, both during intervention and in the postoperative course.
The authors, after explaining why they were persuaded to effect a study about the immunological outline of patients in geriatric age, suffering from colorectal carcinoma in different stages, state the methods they adopted for the in vivo and in vitro study of the cellular and humoral immunity. In order to better characterize these subjects, the authors also dosed tumoral markers, specific enough for the large intestine carcinoma, such as CEA and AFP. After reporting the results of their research, the authors, as a conclusion, assert there is certainly a straight correlation between immunity faults, bound to ageing, and neoplastic disease; therefore, the study of the immunological outline in aged patients is very useful, not only for prognostic purposes, but also to monitoring the immunitary state, mot inclined to meet depression in such patients as a consequence of the different therapies performed.
The Authors, after emphasizing melanoma still now represents one of the most aggressive malignant tumours, state the chemoimmunotherapeutic protocol they used in the treatment of this neoplasm. Then, on the basis of the results obtained, they affirm that, although malignant melanoma is considered from long time as a scarcely chemosensitive neoplasm, remarkable advantages can be got through the use of monochemotherapy, especially in association pith the immunotherapy. In fact, by associating both protocols, chemotherapeutic and immunotherapeutic a significant improvement in the prognosis of such neoplasm was obtained, as to both the indices of survival and the gap free from illness.
The authors point out the cytologic test on needle-aspiration report is a method phich, although complementary to clinical examination and mammography, results to be extremely valid and useful for diagnostical purposes and a correct therapeutical programming; they describe the set of instruments and technique they adopted, and point out its easy execution and complete absence of risks. Then, they illustrate the cases they studied, including 86 patient women with both benign and malignant breast pathology, in whom an aspiration biopsy was performed. On the basis of the results obtained, they, as a conclusion, assert the cytologic test with needle-aspiration, although burdened by a fair quantity of false negatives, deserves, for its quick and simple execution, to be included in the breast diagnostical routine, yet without replacing the classic interoperative biopsy for doubtful cases.
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Authors, considering the increasing of the middle duration of life and the increasing of geriatric population, examine various surgical problems in the elderly. They took in consideration not only the age, but all the other markers of surgical risk related to the surgical illness, to the associate illness and to the type of operation. After reporting their experience in the treatment of geriatric patients, they conclude that a scrupulous surgical preparation, a correct indication to the operation and an accurate overseeing after surgery are necessary to do that the elderly patient faces surgical intervention with the same capability of success of the young.
Primary hyperparathyroidism is a hormonal disease that is more and more frequent and is often manifested exclusively by an increase in calcium levels in the serum. After examining the main anatomopathological and clinical characteristics of the disease, the authors present their experience in its diagnosis and surgical treatment. They suggest that cervical exploration with removal of the adenomas and hyperplastic glands in both asymptomatic and highly symptomatic patients is strongly advised. Since it is already possible to obtain an early diagnosis of the disease thanks to multicanal hematochemical equipment, the Authors conclude that in the near future, studies on cellular receptors for calcium will allow new therapeutic treatments to be applied.
After several remarks on the etiopathogenesis of primary hyperparathyroidism the Authors emphasise the importance of follow-up in operated patients. The evaluation begins right after removal of the lesion in the intraoperative phase, in order to evaluate the validity of the intervention and continues with evaluation of mineral homeostasis, disease itself and function of target structures. In addition to possible hypocalcemic crises, special attention should be placed on possible disease recurrence, and the study of all involved parts such as bones, kidneys, pancreas, digestive apparatus as well as the psychological aspects. These are often involved in a significant manner and condition the quality and duration of the patient's life.
The Authors confirm how the advent of mechanical suture has directed the management of rectal carcinoma to an increasingly conservative attitude. In reporting their experience--which consists of about twenty years (222 patients) they specify how not only an increased incidence of recurrence has not appeared, but they have also observed a reduction of theirs (-5.2%). They then attempt to outline basic moments which have characterized the history of rectal carcinoma surgery and they state how today, 80 years since it was conceived, Miles' intervention maintains its validity, even if with more restrictive indications.
The authors relate their statistic about mesenteric infarction in the last five years and they get out the starting point in order to check the characteristics of a disease, which is today distinguished by an infaust prognosis. After few mentions about etiopathology and pathologic anatomy they keep their attention on clinic manifestations of disease and on diagnostic research. After dealing with medical and surgical therapy they declare how more refined diagnostic technique could help early diagnosis and consequently decrease morbidity and morbidity, which are completely unacceptable.
A series of 8 patients with spontaneous rupture of the esophagus is analysed. Correct diagnosis is difficult. The time lapse between the rupture and diagnosis nevertheless seems to be the most important single factor in the outlook for treatment of spontaneous rupture of the esophagus. Early primary closure of the tear and good drainage of the mediastinum and pleural cavity give the best results in such cases. Sometimes a conservative management should be advocated for the treatment of esophageal perforations.
Haemorrhage is perhaps the most terrible complication of portal hypertension whatever is the etiopathology. The authors point out how sclerotherapy of the varices is either a prophylaxis and a therapeutic procedure with a low rate of local and systemic complications. Even if they are supported by good results in personal experience, the authors notice as important is to tailor the treatment for each patient.
In this paper the Authors describe their own experience in applying informatics at the Surgical Division III of Azienda Policlinico Universitario of Messina. After a discussion about existing hardware (LAN of PC) and daily used software (commercial suite) for managing the clinical reports and correlated data (images, medical prescription, reservations, and so on), their conclusion is that a great development on this way will be possible with extension of the services to all the business network and then to WAN as Internet.
The Authors report their experience with the treatment of Spigelian hernia. After addressing the anatomy of the abdominal lateral wall and of etiopathogenic factors responsible for this rare type of hernia, the clinical problems associated with the disease are discussed and the importance of physical examination and instrumental procedures is stressed. The authors then go on to list the possible repair techniques currently available.
In confirming that intrahepatic gallstones don't represent a frequent disease in western countries, Authors specify how this incidence is going to grow up slowly, but in a progressive way. In reporting their experience since 1980 to nowadays they point out how different diagnostic procedures and therapy way of acting were in the first and in the second deca. After having explained actual therapeutic direction that is described in literature, they finish by stating how this is often conditioned by complex anatomicopathological picture and by seriousness of hepatic damage that often comes with intrahepatic lithiasis.
Anastomotic leakage represents the most dangerous complication in digestive surgery and, particularly, in colorectal one. Indeed a careful evaluation and modification of all possible risk factors and a correct procedure aren't often enough to overcome a potential postoperative leakage or at least material filtration. The Authors review their series to analyse the role of all possible general and local risk factors and to verify what conditions can suggest an two or three stages operation.
Jejunum-ileum stromal tumors give diagnostic and therapeutical problems, especially with regard to histopathological identification and biological behavior. These tumors are very rare in all case report. After gastric stromal tumors these ones are the most frequent of all alimentary tract. They are often incidentally found; because of their potential transformation, they have to be treated by respecting oncologic eradication standards and observing prognostic criteria based on a correct histopathological evaluation (neoplasm localization and dimension, its structure, presence of cytological atypisms, mitotic index, ploidia, surgical resection). Then there has to be a good follow-up program.