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Biomedical subjects

V Pugliese

Publications and source records attributed to V Pugliese.

At least 37 records · Page 2Linked to original sources
PubMed1993

DNA aneuploidy is an independent factor of poor prognosis in pancreatic and peripancreatic cancer.

The purpose of this study was to investigate the clinical significance of DNA ploidy, as assessed by flow cytometry, for pancreatic and peripancreatic cancers. Between 1988 and 1990, we examined fresh/frozen samples from 49 patients who had histologically confirmed adenocarcinomas of the bilio-pancreatic carrefour: They had 23 cancers of the pancreas, 21 of the Vater's papilla, and 5 of the common bile duct. All patients were selected among a cohort of subjects who underwent Endoscopic Retrograde Cholangio Pancreatography (ERCP) and/or surgery. No prognostic impact of age, sex, stage, and surgical treatment on survival was observed by univariate analysis. When the affected organ was considered, a statistically significant difference in survival was observed: At 88 wk, survival was 0% for pancreatic and common bile duct cancer patients, and 18.2% at 175 wk for Vater's papilla cancer patients (p = 0.04). In addition, we found, irrespective of affected organ, that the patients with DNA diploid tumors had a statistically significant survival advantage as compared to those with DNA aneuploidy (p = 0.02). Furthermore, the statistically significant prognostic power of DNA ploidy was confirmed when patients with tumors of the pancreas and those with tumors of the Vater's papilla were separately analyzed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1992

[Diagnostic usefulness of BAEPs. A clinical case].

We report the clinical case of a patient operated for a right extracerebral haematoma. In the immediate post-operative period, although no clinical signs were present, a BAEP examination (showing the lack of the V) warned of a pathological condition which was ascertained by CT. A second haematoma was observed, contralateral to the first, and immediately removed. In this case, therapy was based on the neuroelectrophysiological findings.

Adult↗
PubMed1989

Endoscopic papillosphincterotomy and surgical sphincteroplasty for the treatment of bile duct stones: a comparative analysis.

UNLABELLED: One hundred and ten subjects with cholelithiasis entered this retrospective study. Early and late results of 73 patients treated by endoscopic papillosphincterotomy (EPST) were compared to those of 37 patients who had surgical transduodenal papillo-sphincteroplasty (SST). The comparative analysis was made in terms of clinical, biochemical and ultrasonographic findings. The follow-up period ranged from 1 to 5 years in the first group and from 1 to 15 years in the second group. EPST and SST proved to be comparable in regard to operative mortality and morbidity. EPST failed in removing large or impacted bile duct stones in 47% of cases, while SST was uniformly successful. Long-term results were good in most patients, either when treated by EPST or SST. The 5-year failure rate was 8% after EPST and 0% after SST. In the surgical group, the 15-year failure rate was 5%. Serum alkaline phosphatase levels were higher after EPST than after SST, suggesting the persistence of some degree of biliary stasis in endoscopically managed patients. Pneumobilia was detected more often in surgical patients, indicating that SST does create a wide and permanent communication between the duodenum and the biliary system. IN CONCLUSION: 1) EPST may achieve acceptable success rates with low mortality and morbidity, even in high risk patients; 2) the high number of long-term good clinical results seems to indicate that sphincter re-stenosis after EPST is rare, at least for the first 5 years from operation; 3) SST is an effective and safe procedure, ensuring excellent long-term results, provided that the technique of and the indication for are correct (including Wirsung assessment); 4) the wide and permanent stoma created by SST is not associated with recurrent cholangitis, if bile duct re-stenosis does not occur.

Ampulla of Vater↗
PubMed1988

CA 19-9 and CA 50 in benign and malignant pancreatic and biliary diseases.

Serum concentrations of the CA 19-9 and CA 50 antigens were determined in 129 patients with malignant and benign biliary and pancreatic diseases. Values for the two markers were highly correlated (P less than 0.001). The concentrations of CA 19-9 and CA 50 were positive in 84.6% and 80.7% of patients with pancreatic cancer, respectively. The overall specificity of CA 19-9 (92.4%) was slightly higher than that of CA 50 (88.5%). The sensitivity of CA 50 (91.3%) was greater than that of CA 19-9 (73.9%) in patients with diseases of the biliary tract. Elevated concentrations of CA 19-9 (12.9%) and CA 50 (35.2%) were also found in a number of cases with benign disease, especially in patients with obstructive jaundice. These data suggest that both CA 19-9 and CA 50 can be useful markers of pancreatic cancer in nonjaundiced patients. The joint use of the two markers does not yield a better diagnostic resolution than the use of either one alone.

Adenocarcinoma↗
PubMed1987

Tissue sampling from the common bile duct through endoscopic retrograde cholangiopancreatography, endoscopic papillo(sphinctero)tomy and drainage in juxtapapillary malignancies.

In 22 patients with radiological evidence of a malignant stricture or an obstruction of the common bile duct, endobiliary tissue specimens were obtained through endoscopic retrograde cholangiopancreatography. An endoscopic papillo(sphinctero)tomy was necessary in 9 of the 22 patients. The following techniques were employed: (1) forceps biopsy of the papillary infundibulum and/or of the common bile duct; (2) brush cytology in the same sites as above; (3) biliary juice cytology obtained by a nasobiliary drainage tube. In 8 patients, two different sampling techniques were used. The final diagnosis was established by means of pathological evaluation of surgical or necroscopic material. The diagnostic adequacy was 100% for biopsy, 88% for brush cytology, and 62% for bile cytology. The sensitivity was 100%, 66%, and 25%, respectively, for the above techniques. From 6 cases without biliary cancer, the specificity was 100%. These data show that biopsy specimens alone provide a definitive preoperative diagnosis in most cases, provided adequate samples are obtained.

Aged↗
PubMed1986

Cancer of the pancreas: clinical outcome in 76 cases.

A final diagnosis of pancreatic cancer was established in 76 consecutive patients during 4 years. The clinical outcome was evaluated retrospectively, as well as clinical presentation and its impact on the rate of resectability. Even though the diagnostic techniques showed a high sensitivity, only 18.4% of patients had a radical resection performed. In 77.6% of the cases a tissue diagnosis had been obtained. However, in only 1/5 of them was the tissue proof obtained preoperatively. This review confirms that the survival of patients with pancreatic cancer is poor, with slight advantages in the few resectable cases. Therefore, an earlier diagnosis should be attempted in high-risk symptomatic patients, selected by means of nonaggressive tests and evaluated by means of more accurate diagnostic techniques, when suitable.

Adult↗
PubMed1986

The clinical significance of gastric epithelial dysplasia.

Six-hundred-and-ninety-four patients with localized gastric lesions (ulcers, polyps, enlarged or irregular folds, erosions and tumors) underwent endoscopic examination and multiple biopsies. Twenty-nine proved to have severe or moderate gastric epithelial dysplasia. Another group of 123 patients were submitted to endoscopic examination and multiple biopsies, but showed no evidence of localized gastric lesions. Only one case of mild dysplasia was observed in this group. Of the 29 patients with dysplasia, 8 (27.5%) had a carcinoma in the surgical specimen. The endoscopic follow-up carried out in non-operated patients with dysplasia did not show any development of malignancy. This study shows dysplastic changes significantly associated with prominent or depressed lesions of the gastric mucosa at endoscopy. In operated patients a synchronous carcinoma is often detected in the surgical specimen.

Adult↗
PubMed1985

Esophageal dilation in malignant dysphagia.

Esophageal dilation by means of guided Neoplex (Medoc) tubes in 38 patients with malignant obstruction of the esophagus was analyzed. Peroral dilation proved to be a simple, well-tolerated primary procedure in the management of malignant strictures. Most patients have a temporary improvement of dysphagic symptoms, but the benefit appears to decrease progressively in successive dilatatory sessions. Dilations were more difficult, with a 10% perforation rate, in previously radiated patients. Esophageal dilations may play a complementary role in addition to other palliative techniques in the management of malignant dysphagia.

Aged↗
PubMed1984

Outcome of follow-up programs in patients previously resected for colorectal cancer.

The survival of a group of 115 patients (group A) who entered a follow-up program after apparently "curative" surgery for colorectal cancer was compared with that of 62 similar patients (group B) who did not join such a program. No significant difference was found. Clinical benefits to single patients in group A, in terms of anticipated diagnosis and effective treatment of recurrences and of metachronous neoplasias, appeared to be, if any, extremely limited. In light of the high costs of intensive follow-up programs, it is concluded that their use can be justified only within controlled perspective trials aimed to evaluate their usefulness.

Actuarial Analysis↗
PubMed1984

Adenomatous polyps and familial incidence of colorectal cancer.

The frequency of colonic adenomatous polyps and the incidence of colorectal cancer in close relatives were evaluated in a prospective study performed in 100 consecutive patients operated on for colorectal cancer. One hundred patients matched for age and sex, in whom double contrast enema and colonoscopy failed to show cancer, served as control group. Colorectal carcinomas in first-degree relatives were found in 11% of the surgically treated patients and 6% of the control group (the difference is not statistically significant). Solitary or discrete adenomas in patients operated on for colorectal carcinomas were significantly more frequent (32%) than in the control group (18%) (P less than 0.05). This difference is also statistically significant when considering only those patients without relatives suffering from carcinoma; however, the same cannot be statistically proven with the small group of patients with a positive family history. Present findings do not indicate that single or discrete adenomas synchronous with colorectal cancer are significantly associated with a familial history of large bowel malignancy. These findings are consistent with the hypothesis of environmental factors being involved in adenoma pathogenesis.

Aged↗
PubMed1984

Evaluation of a new tumor-associated antigen in pancreatic cancer.

This study was carried out to assess the diagnostic accuracy of a new gastrointestinal cancer antigen ( GICA ) defined by a monoclonal antibody. Its sensitivity and specificity were assayed in a group of patients with different pancreatic diseases (10 acute pancreatitis, 27 chronic pancreatitis, 22 cancers of the pancreas) and in 29 normal individuals. The concentration of GICA was always inferior to 37 units/ml (our discriminant limit between cancer and noncancer patients) both in cases with chronic pancreatitis and in healthy subjects. Increased levels of the antigen were found in 16/22 (72.7%) pancreatic cancer patients and in 3/10 (33.3%) cases with acute pancreatitis. The assay was within the normal range in 2 (28.6%) out of 7 cancers judged resectable. The test is simple and rapid, but its relative sensitivity and the frequent elevation of GICA in other adenocarcinomas of the gastrointestinal tract make it unsuitable for screening programs in pancreatic cancer. Even its use for early diagnosis of cancer of the pancreas does not seem promising. The major finding of our study is the lack of false-positives in patients with chronic pancreatitis and therefore the usefulness of this test in differentiating preoperatively between chronic inflammation and cancer of the gland. Frequent increase of the marker in patients with acute pancreatitis is not yet clear.

Adenocarcinoma↗
PubMed1984

Occult blood testing in asymptomatic patients previously resected for colorectal cancer.

Hemoccult testing was carried out in 100 patients who had previously undergone surgical resection for colorectal cancer. Of the 15 Hemoccult-positive patients detected, endoscopic examination revealed polypoid formations in six (one with invasive carcinoma) and local recurrent tumors in three. Eighteen polypoid lesions were endoscopically detected in 10 Hemoccult-negative patients. Patient acceptance was good (above 90%) for Hemoccult testing especially when compared to the significantly lower compliance to endoscopic examination (66% in Hemoccult-negative patients). The results suggest that a significant number of lesions may be missed if the Hemoccult test is heavily relied upon exclusively for follow-up of patients previously resected for colorectal cancer.

Adult↗