Autologous fibroblasts transplant after infliximab administration: a new approach in Crohn's perianal fistulas? Brief clinical report.
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Antibodies, Monoclonal↗
Biomedical subjects
S Occhionorelli
Publications and source records attributed to S Occhionorelli.
Polyamine levels and ornithine decarboxylase activity in blood and erythrocytes in human diseases.
Serum and erythrocyte levels of the polyamines spermine, spermidine and putrescine, as well as ornithine decarboxylase in erythrocytes, were studied in patients with different neoplasms (breast, lung and colon cancer) and in those with a nonmalignant proliferative disease (familial polyposis). The blood levels of polyamines and the spermine/putrescine ratio were significantly higher in all tumors and in nonmalignant colon polyposis. In erythrocyte ornithine decarboxylase activity, spermine and spermidine levels, as well as spermidine/putrescine and spermine/putrescine ratios showed a significant decrease after surgery and chemotherapy. Our data suggest that high levels of blood polyamines and erythrocyte ornithine decarboxylase activity are related to cell proliferation and cancer treatment, but that levels of polyamines in serum and erythrocytes are still significantly high after cancer treatment and are similar to those in polyposis disease. Polyamines are related to nuclear activity during differentiation; therefore, the altered turnover of polyamines could be a sign of abnormal nuclear function. Since polyamines stimulate protooncogene expression, their high levels could be considered an important cofactor in malignant cell transformation.
Adenocarcinoma↗
Gastro-intestinal stromal tumor (GIST): case report.
Gastro-intestinal stromal tumors (GISTs), as currently defined, represent the largest category of primary non epithelial neoplasms of the gastrointestinal tract. They arise from mesenchymal cells located in the wall of the organ and show a remarkable variability in their differentiation pathways. For this reason there is relevant degree of confusion in their interpretation. On the basis of immunohistochemical and ultrastructural studies these neoplasms are divided into several categories: leiomyomas, schwannomas and less differentiated tumors referred as GIST. In the small bowel GIST are uncommon. Usually asymptomatic, they could be the cause of surgical emergencies like massive bleeding, obstruction, intussusception or perforation. Generally benign, an higher percentage of malignant cases are described in the small bowel. The Authors report a case of malignant GIST of the small intestine presented with bowel obstruction by ileal invagination. In this case, as usually it happens in malignant GIST, the final diagnosis was obtained by an abdominal surgical exploration.
Aged↗
[Gastric antral vascular ectasia (GAVE or watermelon stomach): a case report].
Gastric antral vascular ectasia (GAVE), recently described in literature, is an important cause of gastric bleeding. A case of great gastrectasia with vascular ectasia in an elderly male patient is reported. The lesion was characterized by great linear and brush folds along the antrum and body of the stomach, Endoscopically, this folds seems like the watermelon streakings. It could be an acquired lesion probably linked to traumatism on gastric mucosa.
Aged↗
Aneurysm dissection of the extracranial internal carotid artery.
Aneurysm of the extracranial internal carotid artery is a rare event. This is a pathology with an elevated mortality of 70%. The most important etiologic factor is atherosclerosis. Here we report a case of surgically treated extracranial internal carotid artery (ICA) aneurysm. A 77-year-old man noticed a laterocervical pulsatile mass. Color Doppler ultrasonography revealed an ICA aneurysm related to a parietal thrombosis. The ICA aneurysm was confirmed by intra-arterial digital subtraction angiography, and cerebral computer tomography (CT) was negative. Surgical treatment reconstruction with the interposition of a part of the great saphenous vein was indicated. Exploration of the aneurysmatic wall revealed a posterolateral dissection. In this paper are discussed clinical and therapeutic implications.
Aged↗
Symptomatic abdominal aortic aneurysm and "situs viscerum inversus." Diagnostic and therapeutic approach.
BACKGROUND: We report one case of symptomatic aneurysm of infrarenal abdominal aorta in a patient symptomatic for acute abdomen. METHODS: The patient was accepted at the Emergency Care Unit and the routine admission tests were taken. US of the abdomen revealed a < > (SVI) disposition of the organs and an aneurysm of the abdominal aorta below the renal arteries. Patient underwent an aorto-aortic straight graft CONCLUSIONS: In this case-report we show SVI cannot be considered a problem in the surgical treatment of symptomatic abdominal aortic aneurysms.
Abdomen, Acute↗
Intraoperative H/R echography for carotid surgery.
BACKGROUND: Intraoperative duplex examination can be used during carotid surgery to identify small technical defects (like anastomotic stenosis, intimal flaps or subintimal wall dissections) that cannot be easily found by palpatory manoeuvres. The objective of this clinical study is to correlate intraoperative duplex findings with early postoperative complications and with duplex data obtained during follow-up. METHODS: From January 1993 to January 1996 we compared early and late postoperative complications that occurred after carotid surgery in two groups of patients: a group of 120 patients undergone intraoperative duplex compared with a group of 100 patients not undergone intraoperative ultrasound. RESULTS: The percentages of early and late postoperative complications which occurred in the first group were respectively 7.5% and 4.2% contrary to 10% and 7% occurred in the control group. CONCLUSIONS: Duplex constitutes a selective intraoperative method for carotid surgery, easy to use, enable to identify and immediately correct technical defects.
Aged↗
Seasonal variations in the rupture of abdominal aortic aneurysms.
From 1982 to 1994, 54 patients (47 men; mean age 72 years) were referred to the Hospital of Ferrara, Italy for spontaneous rupture of abdominal aortic aneurysm. Sixteen died in the emergency department and 38 underwent urgent surgery. Day and month of onset of acute symptoms leading to urgent surgery were recorded. A seasonal variation with significant peaks in spring and autumn was found. These findings are likely influenced by local environmental, social and epidemiological factors, but may be relevant for the appropriate timing of the follow-up and therapeutic strategies for abdominal aortic aneurysms.
Aged↗
One-wound laparoscopic cholecystectomy.
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Cholecystectomy, Laparoscopic↗
Peritoneal cystic mesothelioma treated with minimally invasive approach.
A case of peritoneal cystic mesothelioma in a young woman was treated with a minimally invasive approach. The technique and a review of the literature are presented.
Adult↗
[Emergency laparoscopic surgery].
The acute abdomen continues to be a large part of the general surgeon's workload. The continuing advances in laparoscopic surgery have already permitted many emergency procedures to be performed by this route. Since 1993 the Authors perform an explorative laparoscopy in patients with acute abdomen. Once the diagnosis is verified, the endoscopic view suggests to continue the intervention laparoscopically or to convert the procedure. 70 acute cholecystitis, 57 acute appendicitis, 15 perforated peptic ulcers, 6 gynaecological emergencies, 8 intestinal occlusions and 2 splenic traumas were treated according to this approach. The results obtained testify that laparoscopy is a valuable diagnostic tool for the surgeon in case of acute abdomen and an interesting therapeutic alternative in selected cases. However, it requires extensive experience in laparoscopic techniques.
Abdomen, Acute↗
[Experimental study of postoperative lavage: standardization of the method].
Postoperative infections are an outstanding problem in a surgical department. We have been studying them from a clinical and experimental point of view has a long time. In this study we present a method standardisation of postoperative peritoneal lavage as prevention of surgical infections. Winstar mice, infected with intra peritoneal E. coli cultures, underwent peritoneal lavage with saline solution or sterile water. The results showed the right amount of solution and the exact administration of lavage according to grade of infection. Encouraged by this result we are going to test the efficacy of anti microbial agents for the postoperative peritoneal lavage.
Animals↗
[Aneurysms of the popliteal artery. Our experience apropos of 37 cases].
The authors describe their experience concerning the surgical treatment of aneurysmatic pathology of the popliteal artery. This is the most frequent site for aneurysm after aortic aneurysm. Since 1979 to 1994, 26 patients, 21 men and 5 women (mean age 65.8 years), have been treated at the Institute of Clinical Surgery of the University of Ferrara for a total of 37 popliteal aneurysms. Thirteen patients had more than one aneurysm. Before the operation, all patients underwent DSA, and echo Doppler, 7 with CAT and 4 with RMN. Twenty-nine substitutions, 7 by passes and 1 ligation were performed. Twelve of the 29 substitutions were made by reversed saphenous vein. Fourteen by PTFEe, and 3 by dacron. In 4 cases it was necessary to reimplant either the anterior tibial artery (3 cases) or the posterior tibial artery (1 case) separately. The results obtained were good especially in the post-trauma patients. Only 3 amputations were necessary due to graft obstruction immediately after surgery, and in post-traumatic conditions.
Aged↗
[Contribution of a combination of alpha and beta benzopyrones, flavonoids and natural terpenes in the treatment of lymphedema of the lower limbs at the 2d stage of the surgical classification].
HYPOTHESIS: To create a phlebolymphologic therapy in order: to activate venous system; to activate lymphatic system; to activate macrophagic system; to reduce the proteic lymphatic load. EXPERIMENTAL: A study was performed on the use of an ideal phlebolymphological association (Tonka Beans, Gingko Biloba, Melilotus Officinalis) as a practical standpoint in the treatment of lymphedema of lower limbs in order to create an efficacious dose of Coumarin, Benzopyrones and Ginkolidi. CLINICAL: We investigated a population of 76 patients treated in an open-label study for six-eight months with a dosage of Coumarin 60 mg/daily + Gingko Biloba 40 mg/daily + Melilotus 40 mg/daily. CONCLUSION: This trilogy induced a very significant improvement in lymphedema (centimeter-aspect) both in functional symptoms (pain heaviness in affected limbs) and physical signs (edema, episodes of infection). Tolerance of long term treatment was good and the improvement was observed from the third month of treatment.
Adolescent↗
Gasless video-assisted reversal of Hartmann's procedure.
More than 60% of patients who are submitted to Hartmann's procedure refuse to undergo reversal. This procedure is in fact a major undertaking associated with significantly mortality and morbidity rates. The authors suggest a minimally invasive approach without pneumoperitoneum. A consecutive series of four male patients, average age 64 years, underwent laparoscopic assisted reversal of Hartmann's procedure in our department. The procedure was performed for intestinal malignant occlusion in two cases and for perforated diverticulitis in the other two. Mobilization was nearly immediate and incisional pain almost absent; peristalsis restarted after 36-48 h. Finally, the patients were discharged on day 6. Neither mortality nor morbidity occurred in the 8-month follow-up period. The authors conclude that this new laparoscopic procedure may lead to shorter hospital stays and increased acceptance by patients, while maintaining the same safety of the traditional open procedure.
Colon, Sigmoid↗
[Use of PGE1 in severe ischemia of the lower extremities. Clinical study].
Lower limb critical ischemia is a clinical condition typical of patients with severe chronic obstructive arterial disease (Fontaine's IIIb and IV degree). This condition often leads to amputation of the limb involved. The authors present to the use PGE1 in 50 patients with Fontaine's IIIb-IV degree chronic obstructive arterial disease of lower limbs in which the indication of amputation was done. All the patients, admitted to the emergency ward, complain of rest pain and distal ulcers. The administration of PG5(1) was given as follows: 40 mg/bid/e.v./20 days. A 6 months long follow-up was installed with the instrumental evaluation of: Transcutaneous oxygen pressure; Distal blood perfusion with Doppler; cardiac pulse; blood pressure. Eighteen patients became to a Fontaine's II degree during the next 2 months after therapy, 25 patients came back to a severe claudicatio: of them 18 underwent successfully vascular surgery, 7 underwent amputation of the lower limb. In 7 patients the PGE1 did not influence the natural progression of the disease. Among the side-effects of therapy we can mention: headache (4%), erythema and pain of injected vein (8%), sick (4%). All the side effects were transient and never led to interruption of therapy.
Aged↗
[Intimal hyperplasia following vascular procedure. An unresolved problem].
Many pathophysiological mechanisms have been postulated for the development of intimal hyperplasia following arterial reconstructions that can lead to restenosis. The central theme appears to be injury to the endothelial cell. A number of pharmacological therapies have been proposed for the control of intimal hyperplasia, but at the current time this is managed by surgical reconstruction. Modification of the hyperplastic response by the newer pharmacological therapies requires further experimental and clinical studies. The definition of specific factors responsible for particular cellular events in the injured artery will make the right pharmacological treatment possible.
Arteriosclerosis↗
[Video-assisted atypical resection of peripheral lung nodules localized using CT-guided wires. First clinical experiences].
One of the reasons for the rapidly expanding use of thoracoscopic surgery as an alternative to thoracotomy, is the excision of peripheral lung nodules. Nodules judged too small or too far from the pleural surface to be seen during thoracoscopy, must be localized beforehand. The aim of this study was to evaluate the feasibility and effectiveness of percutaneous placement of needle hook-wires to locate such nodules before surgery. Under Ct guidance 5 nodules were pre-operatively identified in 4 patients. The thoracoscopic resection of the lesions was done without complication, in 1 patient the operation had to be converted into an open one to dislodge of the wire. CT-guided hook-wire localization is easily and safely performed and permits thoracoscopic resection of lung nodules, which otherwise might be impossible.
Aged↗