Biomedical subjects
Publications and source records attributed to V Parisi.
Gastric carcinoma cases have been classified according to Lauren's system. The intestinal and diffuse histotypes are compared, and correlated with the epidemiologic data, type of operation and follow-up. The results show that total gastrectomy is indicated in diffuse carcinoma.
PURPOSE: To evaluate the neural conduction along crossed and uncrossed visual pathways in patients with ocular hypertension (OHT). METHODS: Fifteen patients (mean age 59.1+/-6.8 years) with OHT (IOP>22 mmHg, Humphrey 24-2 with mean deviation [MD]>-2 dB) were enrolled. They were compared to 15 age-matched controls. In OHT patients and control subjects, visual evoked potentials (VEPs) were recorded using full-field checkerboard patterns (the check subtended 15' of visual arc; contrast 80%) reversed at 2 Hz. VEP responses were simultaneously recorded in the homolateral visual cortex (HC) and in the contralateral visual cortex (CC), with respect to the stimulated eye. RESULTS: In OHT patients, VEP P100 implicit times observed in HC and CC were both significantly delayed (analysis of variance, p<0.01) when compared to those of controls, and, in particular, longer in CC than in HC. The interhemispheric differences (ID: P100 implicit time in HC - P100 implicit time in CC) were significantly higher in OHT patients than controls (-3.16+/-1.80 msec and 1.16+/-1.04 msec, respectively, p=0.001). In OHT patients we observed an MD hemifield difference (difference between nasal and temporal MD values) higher than in controls (-0.82+/-0.80 dB and 0.04+/-1.03 dB, respectively, p<0.01) and significantly correlated with the ID (r: 0.836, p<0.001). CONCLUSIONS: The observed asymmetry in the bioelectrical cortical responses and in the visual hemifield parameters suggests that crossed visual pathways could be impaired earlier than uncrossed visual pathways in OHT patients.
PURPOSE: To assess nerve conduction in visual pathways in patients with open-angle glaucoma. METHODS: Pattern-electroretinograms (PERG) and visual-evoked potentials (VEP) were simultaneously recorded in 16 patients with open-angle glaucoma (POAG) and 15 age-matched controls. The visual stimuli were checker-board patterns (the check edges subtend 15'; the contrast was 70% and reversed at the rate of 2 reversals/s). RESULTS: POAG patients showed significantly higher PERG and VEP latencies (ANOVA: P < 0.01) and significantly lower amplitudes than controls; the retinocortical time (RCT: difference between VEP P100 latency and PERG P50 latency) was longer (P < 0.01) in POAG than controls and the longer RCT was correlated with the reduced PERG amplitude (r:0.798, P < 0.01). CONCLUSIONS: This suggests that POAG patients have an involvement of the innermost retinal layers and impaired nerve conduction in their visual pathways.
Pancreatic carcinoma is an aggressive disease and its prognosis is dismal. Patients present with an advanced stage of disease and only a small number of patients undergo resection with a curative intent; thus the 5 years survival rate is very low. Several improvements have been made in the surgical approach with a decrease in perioperative morbidity and mortality. Results offered by chemotherapy and radiotherapy remain unsatisfactory despite a number of new drugs and considerable advancements in irradiation techniques. Jaundice, pain and gastrointestinal obstruction are the main clinical problems to be dealt with in advanced patients. Surgical palliation still represents a widely preferred option but non surgical approaches appear promising. The Authors analyse the possible options in palliation for pancreatic carcinoma. The various surgical procedures for biliary by-pass are described. Hepaticojejunostomy is the operation of choice and offers the best results in terms of quality of life and time of palliation. A possible role for resective operation also in advanced cases has been proposed by some groups and is gaining wide acceptance in referral centres where low morbidity and mortality are now routine. Percutaneous and endoscopic approaches to jaundice represent a valid alternative in some patients with a low life expectancy and in those centres with a high experience. Gastrointestinal by-pass in symptom-free patients or advanced cases only is an unsolved dilemma. New approaches such as locoregional chemotherapy with curative or neoadjuvant intent are also described in this paper. Many chemotherapic agents have been tested in various settings and appear to offer promising results in palliation and also, in some cases, in downstaging tumors then amenable to resection. Pain control is a major aspect in management of advanced pancreatic carcinoma. Appropriate pain therapy has to be established in all patients in order to obtain a better quality of life. Various options are available such as intraoperative alcohol injection or CT guided percutaneous splanchnicectomy. Palliation in patients with pancreatic carcinoma is a major aspect of management because of the high percentage of non curable cases; multimodality approach is mandatory and all possible problems have to be dealt with in order to increase survival and, more importantly, quality of life.
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Explore the source record for details and available documents.
BACKGROUND AND PURPOSE: Preoperative chemoradiation allows downstaging of locally advanced rectal cancer and in selected patients also a sufficient downsizing to ensure sphincter preservation. Selection of patients warranting a preoperative approach is improved by magnetic resonance imaging (MRI) which is able to define the involvement of mesorectal circumferential margin. Similarly it would be crucial to define the response to chemoradiation during the treatment but traditional morphologic imaging techniques may fail in differentiating neoplastic tissue from scarring. PET-FDG has been successfully used in the detection of metastatic colorectal cancer allowing imaging of deposits as small as 0.5 cm and may have a role in evaluating early response to chemoradiation. METHODS: In the present study, in patients with T3-T4 rectal cancer undergoing preoperative chemoradiation PET-FDG and flow cytometry analysis on endoscopic biopsy specimen have been performed before, during and after preoperative chemoradiation. RESULTS: Chemoradiation treatment has been successful in terms of downsizing and downstaging of the tumor. PET-FDG was able to demonstrate local response at only ten-fifteen days after the beginning of neoadjuvant therapy, also identifying non responding patients. CONCLUSIONS: FDG-PET may have a role in defining the response to chemoradiation and modulate the treatments strategy in patients with advanced rectal cancer.
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Haemostatic system compounds not routinely studied, have been evaluated to define the individual risk of VTE (venous thromboembolism) and to influence the prognosis using selective drugs. Significantly high values of fibrinogen, free-TFPI, F1 + 2 fragments and TAT complexes on coagulation side and PAI-1 and TAFI on fibrinolysis side have been detected. Thrombin seems to have a role in the inhibition of TAFI dependent fibrinolysis not inhibited by heparin.
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PURPOSE: To evaluate the changes in visual acuity (VA) and in macular sensitivity in myopic eyes subjected to laser in situ keratomileusis (LASIK) refractive surgery. METHODS: In 38 myopic eyes, VA by Snellen's table and macular sensitivity by scanning laser ophthalmoscope (SLO) microperimetry were assessed before and after 24 weeks after LASIK surgery. The myopic eyes were divided into three age-matched groups: Group A = from -5 diopters (D) to -7 D and normal SLO-macular sensitivity (15 eyes); Group B = from -8 D to -16 D and normal SLO-macular sensitivity (9 eyes); and Group C = from -8 D to -16 D and abnormal SLO-macular sensitivity. RESULTS: Group A and B eyes, at the first week after LASIK surgery, we observed a significant analysis of variance, p<0.01) reduction in VA and SLO-macular sensitivity with respect to baseline values, while after 12 and 24 weeks no differences (p>0.01) were found when compared to baseline. In Group C patients, at 1 and 4 weeks after surgical treatment, we observed a significant (p<0.01) reduction in VA and SLO-macular sensitivity with respect to baseline values. At 12 and 24 weeks the values of VA were reduced, but not significantly (p>0.01), while values of SLO-macular sensitivity were still significantly (p<0.01) reduced. CONCLUSIONS: LASIK could induce a reduction in VA and SLO-macular sensitivity in all myopic eyes during the 4 weeks following the surgery. This reduction is still present after 24 weeks only in eyes with the highest preoperative degree of myopia combined with the greatest reduction in macular sensitivity.
Composite pelvic resection with sacrectomy may provide good local control in case of locally advanced rectal cancer infiltrating the sacral bone. A combined multidisciplinary approach including chemotherapy and radiotherapy is here presented for a case of rectal tumor invading the sacrum.
Locally advanced rectal cancer carries out a dismail prognosis despite optimal surgery in terms of local and distant relapses. Neoadjuvant chemoradiation offers good results with tumor downstaging and downsizing and leads to more radical surgery with conservative intent. Selection of patients and an intensive chemotherapy may improve long term results. Our experience with a combined polichemotherapy and radiotherapy for low advanced rectal cancer is presented.
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Uterine leiomyosarcomas carry a dismail prognosis. Diagnosis is often an unexpected pathology discovery after hysterectomy for fibroma. Prognosis depends on the degree of locoregional extension and thus on early diagnosis. Extended surgery in case of relapse is sometimes the only possible approach for symptoms control and improvement of quality of life. A case of massive involvement of the abdomen by a relapsed uterine leiomyosarcoma treated by extreme surgery is here presented.