Biomedical subjects
Publications and source records attributed to V Trancanelli.
Case of stenosis of the left flexure of the colon caused by pancreatitis is reported. The relevant literature is surveyed and an account is given of the pathogenesis of this forms, and the examinations required in its diagnosis, particularly coloscopy. A preference is expressed for an internal colic derivation (colon-colon anastomosis) rather than resection, on account of the smaller degree of risk involved.
A case of intestinal stenosis in a subject who had received an abdominal injury four weeks earlier is presented. The relevant literature is surveyed and the pathogenesis of this unusual condition is examined. Post-traumatic stenosis of the small intestine is seen as an example of ischaemic stenosis.
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Personal experience with glucagon in 15 cases of acute pancreatitis is reported. Complete remission of pain within 2-3 hr after infusion of the drug was noted in 85% of the series, together with normalisation of blood amylase within 48-72 hr. Glucagon inhibits pancreatic secretio&n. Vairous theories concerning its mechanism of action are examined.
Starting from a clinical case in which a trans-obturator by-pass was necessary, the most recent findings as regards the technique of this and its indications are reviewed. The procedure is to be considered a valid alternative in cases of ischaemic revascularization when the usual Scarpa triangle route cannot be used.
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The usefulness of endoscopic examination of patients subjected to vagotomy and drainage for duodenal ulcer is stressed, since it permits recurrences and ineffective treatment to be detected, along with the control of other parameters, such as the appearance of the mucosa, the performance of gastric drainage, the features of peristalsis and gastric tone, and the performance of the cardial sphincter. Data from a series of 43 endoscopies performed after 192 vagotomy and drainage operations carried out between 4-1973 and 5-1976 are presented.
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Rupture of the pericardium due to closed thoracic trauma is a very rare event which is hard to diagnose. It occurs in the form of two main clinical pictures: 1) severe chest trauma with massive haematoma requiring surgery and which permits diagnosis, and 2) precordial pain and clinical signs of pericardiac origin. Surgery is essential in view of the risk of lethal complications from cardia luxation. Operation consists of closure of the pericardiac lesion.
UNLABELLED: INTRODUCTION MATERIAL AND METHODS: From January, 1990, to December, 1995, 138 consecutive patients with radically resected stage II and III rectal and rectosigmoid cancers were treated with adjuvant radiochemotherapy. Eighty-one patients with 24 months' follow-up were assessable. Low anterior resection (LAR) was performed in 64 (79%) patients and abdominoperineal resection (APR) in 17 (21%). Twentynine (36%) stage II and 52 (64%) stage III patients entered the study. Within 45-60 days from surgery all patients received 5-Fluorouracil chemotherapy at the dose of 500 mg/m2/iv/d 1-5, every 4 weeks, for six cycles. Chemotherapy cycles 3 and 4 were administered at the same daily dose on radiotherapy days 1-3 and 29-31. Radiotherapy total dose consisted of 45 Gy/1.8 Gy/day administered in 5 weeks with 18 MV photon beam to the pelvis with the four field "box" technique. Perineal scar was encompassed only after APR. A boost dose of 5.4 Gy to the tumor bed was given in 3 fractions of 1.8 Gy. Median follow-up was 37 months (range: 24-74 months). RESULTS AND DISCUSSION: Overall recurrent disease was reported in 28 of 81 patients (34%): local, systemic and both local and systemic relapses in 9 (11%), 14 (17%) and 5 (6%) cases, respectively. According to local extension, recurrence rates were 10% and 48% in stages II and III, respectively. Five-year overall and disease-free actuarial survivals were 64% and 61%, respectively. Median time to relapse was 15 months (range: 7-43 months). Significant prognostic factors for better tumor control were: stage (II vs III), disease site (proximal vs distal rectum), the surgical procedure (LAR vs APR), the number of involved nodes (< or = 4 vs > 4) and no extracapsular node invasion. The recommended dose of combined radiochemotherapy regimen used in this trial was generally well tolerated. The incidence of any grade > or = 3 acute toxicity (according to WHO grading) was 20% diarrhea, 6% tenesmus and 4% myelosuppression. Five (6%) patients had cronic diarrhea and other 3 (4%) radiotherapy-related severe late toxicity which required surgery. CONCLUSIONS: This study seems to provide similar survival and recurrence notes to other radio-chemotherapy regimens published in the literature. However, a more aggressive approach is warranted in stage III patients considering the low 5-year survival recorded.
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