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Della Rocca G, Pugliese F, Antonini M, Coccia C, Pompei L, Venuta F, Rendina EA, Ricci C. Inhaled nitric oxide during anesthesia for bilateral single lung transplantation. Case report. Minerva Anestesiol 1998; 64:297-301. [PMID: 9763810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Recently inhaled nitric oxide (iNO) has been used as pulmonary vasodilator without any effect on systemic hemodynamics. iNO has been also used in cardiac and thoracic surgery, involving lung transplantation. In this case report a patient, 41 years old female, affected by bronchiectasis, underwent bilateral sequential single lung transplantation and during one lung ventilation and pulmonary artery clamped iNO allowed to avoid cardiopulmonary bypass and to carry out the procedure successfully.
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Bertolotto M, Gioulis E, Ricci C, Turoldo A, Convertino C. Ultrasound and Doppler features of accessory spleens and splenic grafts. Br J Radiol 1998; 71:595-600. [PMID: 9849381 DOI: 10.1259/bjr.71.846.9849381] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
16 splenic grafts and 24 accessory spleens were evaluated with ultrasound, colour Doppler and power Doppler imaging, in order to compare the features of splenic grafts and accessory spleens. 12 splenic grafts (11 surgically implanted, 1 islet of splenosis) were detected in eight patients following splenectomy 6-12 months previously. Four of the surgically implanted splenic grafts were found in three patients following splenectomy 16-18 days previously. 21 accessory spleens were incidentally detected in 20 subjects who had not been operated upon, whereas three enlarged accessory spleens were found in 10 patients who underwent splenectomy 6-12 months previously. The size, shape, rim features, echogenicity, acoustic enhancement and vascularization of the splenic grafts and accessory spleens were evaluated. The splenic grafts were oval with lobulated margins, an inhomogeneous pattern in 36% and acoustic enhancement in 64%. Multiple feeding vessels arising from the surrounding tissue entered the periphery of 10 splenic grafts in the eight patients operated on 6-12 months previously, whereas no vascular signals were detected in the four splenic grafts of the three patients operated on 16-18 days ago. Accessory spleens were round with smooth echogenic margins and a vascular hilum arising from the splenic vessels. In conclusion colour Doppler and power Doppler allow differentiation between accessory spleens and splenic grafts basing on their shape and vascular supply.
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Venuta F, Rendina EA, De Giacomo T, Flaishman I, Guarino E, Ciccone AM, Ricci C. Technique to reduce air leaks after pulmonary lobectomy. Eur J Cardiothorac Surg 1998; 13:361-4. [PMID: 9641332 DOI: 10.1016/s1010-7940(98)00038-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Patients undergoing pulmonary resections often present postoperative air leaks of varying magnitude and duration; this complication is more frequent with incomplete or absent interlobar fissures. Small leaks close spontaneously within 5-7 days; larger leaks may persist longer and could be associated with increased morbidity and prolonged hospitalization. We evaluated the role of different techniques to complete interlobar fissures before pulmonary lobectomy to prevent postoperative air leaks and reduce hospital stay and costs. METHODS A total of 30 patients undergoing pulmonary lobectomy for lung cancer and presenting incomplete interlobar fissures that needed to be opened both anteriorly and posteriorly were randomized into three groups. In Group I, fissures were created with a GIA stapler and buttressed with bovine pericardial sleeves. In Group II, we used TA 55 staplers alone; in Group III we used the 'old fashion' cautery, clamps and silk ties. The three groups were homogeneous for age, type of pulmonary resection and stage of the tumor. The duration of postoperative air leaks and hospital stay were compared with the one-way variance analysis. RESULTS Postoperative air leaks for Groups I, II and III persisted for 2 +/- 0.94, 5.3 +/- 2 and 5.3 +/- 1.7 days, respectively. Mean hospital stay was 4.4 +/- 0.96, 7.8 +/- 2.14 and 7.2 +/- 1.5, respectively. The difference between groups in terms of duration of postoperative air leaks and hospital stay was statistically significant (P = 0.0001). CONCLUSIONS The use of GIA staplers and pericardial sleeves to complete interlobar fissures for pulmonary lobectomy significantly reduces the duration of postoperative air leaks and hospital stay; no complications were associated with this technique.
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Pompeo E, Francioni F, Pappalardo G, Trentino P, Crucitti G, Ricci C. Giant leiomyoma of the oesophagus and cardia. Diagnostic and therapeutic considerations: case report and literature review. Scand Cardiovasc J Suppl 1998; 31:361-4. [PMID: 9455786 DOI: 10.3109/14017439709075954] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A case of giant leiomyoma of the oesophagus and cardia is presented. Magnetic resonance imaging was particularly useful for assessing the relationship of the tumour to the neighbouring structures. Radical resection was performed by partial oesophagogastrectomy with intrathoracic oesophagogastrostomy. Giant oesophageal leiomyomas present a diagnostic and therapeutic challenge because of their size and the possibility of malignant behaviour.
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Venuta F, De Giacomo T, Rendina EA, Della Rocca G, Flaishman I, Guarino E, Ricci C. Thoracoscopic volume reduction of the native lung after single lung transplantation for emphysema. Am J Respir Crit Care Med 1998; 157:292-3. [PMID: 9445313 DOI: 10.1164/ajrccm.157.1.96-09068] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Della Rocca G, Pugliese F, Antonini M, Coccia C, Pompei L, Vizza CD, Rendina EA, Ricci C, Cortesini R. Hemodynamics during inhaled nitric oxide in lung transplant candidates. Transplant Proc 1997; 29:3367-70. [PMID: 9414751 DOI: 10.1016/s0041-1345(97)01110-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Venuta F, Rendina EA, Pescarmona EO, De Giacomo T, Vegna ML, Fazi P, Flaishman I, Guarino E, Ricci C. Multimodality treatment of thymoma: a prospective study. Ann Thorac Surg 1997; 64:1585-91; discussion 1591-2. [PMID: 9436540 DOI: 10.1016/s0003-4975(97)00629-2] [Citation(s) in RCA: 102] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Thymomas are a heterogeneous group of tumors. Treatment of invasive lesions is not well standardized. The aim of this study is to propose a clinicopathologically based protocol for multimodality therapy. METHODS Between 1965 and 1988, we operated on 83 patients with thymoma who did not receive standardized adjuvant therapy. In 1989, on the basis of the retrospective analysis of the data, we started a multimodality therapy protocol and used it for 65 patients. Twelve patients had medullary thymoma (11 stage I and 1 stage II), 13 had mixed type (6 stage I and 7 stage II), and 40 had cortical thymoma (4 stage I, 11 stage II, 12 stage III, and 13 stage IV). We considered three groups. Group I (n = 18 patients), benign thymoma, included stage I and II medullary and stage I mixed thymomas; radical resection with no adjuvant therapy was performed. Group II (n = 22), invasive thymoma, included stage I and II cortical and stage II mixed thymomas; postoperative chemotherapy plus radiotherapy was always administered. Group III (n = 25), malignant thymoma, comprised stage III and IV cortical thymomas and stage III mixed thymomas; resectable stage III lesions were removed, and highly invasive stage III and stage IV lesions underwent biopsy, neoadjuvant chemotherapy, and surgical resection; postoperative chemotherapy and radiotherapy was administered to all patients. RESULTS The 8-year survival rate for patients in stages I, II, III, and IV was 95%, 100%, 92%, and 68%, respectively. Patients with medullary thymoma had a 92% 8-year survival rate; those with mixed type, 100%; and those with cortical thymoma, 85%. Group I had an 8-year survival rate of 94%; group II, 100%; and group III, 76%. Survival was compared with that of patients operated on before 1989: differences were not significant for group I; survival improved in group II (100% versus 81%; p = not significant); and group III showed significant improvement (76% versus 43%; p < 0.049). CONCLUSIONS Multimodality treatment with neoadjuvant chemotherapy and adjuvant chemotherapy plus radiotherapy may improve the results of radical resection and the survival of patients with invasive and malignant thymoma.
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Rocca GD, Coccia C, Pugliese F, Antonini M, Pompei L, Ruberto F, Venuta F, Ricci C, Gasparetto A. Intraoperative inhaled nitric oxide during anesthesia for lung transplant. Transplant Proc 1997; 29:3362-6. [PMID: 9414750 DOI: 10.1016/s0041-1345(97)00944-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Rendina EA, Venuta F, De Giacomo T, Flaishman I, Fazi P, Ricci C. Safety and efficacy of bronchovascular reconstruction after induction chemotherapy for lung cancer. J Thorac Cardiovasc Surg 1997; 114:830-5; discussion 835-7. [PMID: 9375614 DOI: 10.1016/s0022-5223(97)70088-6] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to ascertain the safety and efficacy of bronchial sleeve resection and reconstruction of the pulmonary artery in patients who had undergone induction chemotherapy for lung cancer. METHODS Between January 1991 and July 1996, we operated on 68 patients who had received three cycles of cisplatin-based induction chemotherapy. In 27 of these cases, we performed a lobectomy (n = 25) or bilobectomy (n = 2) associated with reconstruction of the bronchus, the pulmonary artery, or both. In only five additional patients, pneumonectomy had to be carried out. Before chemotherapy, 14 patients were in stage IIIA and 13 were in stage IIIB. All patients in stage IIIB had T4 disease; no N3 cases were included. At thoracotomy, one patient had no evidence of tumor, six were in stage I, 13 were in stage II, six were in stage IIIA, and one was in stage IIIB. Sixteen patients had epidermoid carcinoma and 11 had adenocarcinoma. RESULTS Sixteen patients underwent bronchial sleeve resection; 11 had various types of pulmonary artery reconstruction, associated with the bronchial sleeve in eight cases. In 26 patients, resection was radical with histologically negative margins. Neither bronchial complications nor deaths occurred. One patient had empyema and two had wound infections. Mean chest tube duration was 6 days. After a postoperative follow-up of 4 to 69 months (mean 25 months), 14 patients are alive and free of disease, one is alive with disease, and 12 have died. There were no local recurrences. The 1- and 4-year survival rates are 78% and 39%, respectively. CONCLUSIONS Although it is technically demanding, lobectomy associated with bronchovascular reconstruction is feasible, with good immediate and long-term results, after induction chemotherapy.
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Mauri MC, Fabiano L, Bravin S, Ricci C, Invernizzi G. Schizophrenic patients before and after HIV infection: a case-control study. L'ENCEPHALE 1997; 23:437-41. [PMID: 9488926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Thirteen HIV positive schizophrenic patients (Group 1), age ranging from 23 to 60 years, diagnosed as schizophrenics (DSM IV), were studied during a four week hospitalization period, due to an acute exacerbation phase. The patients were treated with haloperidol (3-15 mg/die p.o.) and diazepam (2-25 mg/die p.o.). Clinical picture and side-effects were assessed by BPRS, HRS-A, HRS-D, and DOTES, at admission and after 2, 3, 4 weeks of hospitalization period (Time 5, 7, 8, 9). Clinical evaluations were compared to a previous hospitalization period, before seroconversion (Time 0, 2, 3, 4), and to a control group (Group 2) of HIV negative schizophrenic patients (11 pb) followed as well during 2 periods of hospitalization. Our data seem to emphasize that the HIV infection could induce organic alterations in the CNS which might cause psychopathological consequences: significantly more severe depressive symptomatology and a reduction of tolerability to neuroleptics in the seroconverted patients' group.
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De Giacomo T, Rendina EA, Venuta F, Della Rocca G, Ricci C. Thoracoscopic staging of IIIB non-small cell lung cancer before neoadjuvant therapy. Ann Thorac Surg 1997; 64:1409-11. [PMID: 9386712 DOI: 10.1016/s0003-4975(97)00764-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Bronchoscopy and imaging techniques are the most valuable tools for noninvasive staging of patients with locally advanced non-small cell lung cancer but their overall accuracy is not satisfactory. Neoadjuvant therapy protocols require strict criteria for patient selection and invasive staging should be carried out to establish standardized inclusion criteria and to homogenize posttreatment results. The aim of this prospective study was to evaluate the role of thoracoscopy in the assessment of the real extent of lung cancer in patients with the clinical suspicion of stage IIIB disease. METHODS From January 1993 to March 1996, we observed 64 patients with suspected IIIB non-small cell lung cancer. Forty-three patients were considered eligible for this study and were divided into three groups: group I, cytologically negative pleural effusion (n = 10); group II, computed tomographic suspicion of mediastinal infiltration (n = 30); and group III, contralateral lymphadenopathy not accessible by mediastinoscopy (n = 3). RESULTS No complications related to thoracoscopy occurred. Of 10 patients in group I, thoracoscopy up-staged the disease to IIIB in 6 (60%). Of 30 patients with suspicion of T4 (group II), thoracoscopy confirmed T4 in 15 patients (50%). Nine (30%) were downstaged to stage IIIA and 2 (6.6%) to stage II. In 4 patients (13.4%) thoracoscopy failed to yield definitive staging. In all 3 patients of group III, thoracoscopy confirmed stage IIIB. CONCLUSIONS Thoracoscopy proved adequate for correct staging in 39 of 43 patients (91%); therefore, it should be considered in the staging work-up of suspected stage IIIB patients.
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Ricci C, Vaccari S, Cavalli M, Vincenzi C. Contact sensitization to sunscreens. AMERICAN JOURNAL OF CONTACT DERMATITIS : OFFICIAL JOURNAL OF THE AMERICAN CONTACT DERMATITIS SOCIETY 1997; 8:165-6. [PMID: 9249286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Para aminobenzoic acid (PABA) derivatives and cinnamate are chemical sunscreens that protect against UVB (290 to 320 nm). They may occasionally produce contact and photocontact sensitization. OBJECTIVE To report a sensitization to octyl-dimethyl-PABA and photosensitization to 2-ethylhexyl-p-metossicinnamate in a 31-year-old man. METHODS A patient with a 3-year history of a relapsing dermatitis involving the face, neck, legs, and knees is reported. The eruption had recurred every summer after sunlight exposure. Patch tests with International Contact Dermatitis Research Group (IC-DRG) standard series and the photopatch series (Hermal-Trolab, Reinbek, Germany) using Finn chambers on Scanpor (Norgesplaster A/S, Oslo, Norway) were carried out. RESULTS We found a positive reaction to Balsam of Peru, fragrance mix, Escalol 507, and Parsol MCX (Hermal-Trolab, Reinbek, Germany). Photopatch test revealed a positive reaction only for Parsol MCX. CONCLUSION The incidence of allergic contact dermatitis to sunscreens is considered low. Recently sunscreens patch test concentrations have been increased from 2% to 10%. These higher percentages will probably permit the identification of more cases of sunscreens allergy in the near future.
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Rendina E, Venuta F, De Giacomo T, Flaishman L, Guarino E, Ciceone A, Ricci C. 382 Is primary surgery for N2 non small cell lung cancer (NSCLC) still justified? Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)89762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rendina Z, Venuta F, De Giacomo T, Flaishman I, Guarino E, Ciccone A, Ricci C. 377 Neoadjuvant chemotherapy for irresectable (T4) non small cell lung cancer (NSCLC). Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)89757-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Morgera T, Sinagra GF, Viel E, Ricci C, Bussani R, Camerini F. The syndrome of right bundle branch block, persistent ST segment elevation and sudden cardiac death. Which is the histological substrate? Eur Heart J 1997; 18:1190-1. [PMID: 9243159 DOI: 10.1093/oxfordjournals.eurheartj.a015421] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Vaira D, Menegatti M, Landi F, Ricci C, Ali A, Miglioli M. Usefulness of serology in preendoscopic screening. The Italian Helicobacter pylori Study Group. Helicobacter 1997; 2 Suppl 1:S38-43. [PMID: 9432353 DOI: 10.1111/j.1523-5378.1997.06b04.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Over the last 20 years, upper gastrointestinal endoscopy has become the investigation of choice for patients with symptoms referrable to the upper gastrointestinal tract. As the increasing number of patients referred for endoscopy has led to enlarged waiting lists and medical expenses, it has been recommended that preendoscopic screening strategies might identify patients at low risk of having major pathology. These patients could avoid prompt endoscopy and might safely undergo different management. Since the recognition of the major role played by Helicobacter pylori in gastroduodenal pathology, H. pylori serological and demographical features have been proposed as part of preendoscopic screening strategies in dyspeptic patients referred to endoscopy, in an attempt to reduce endoscopic workload and medical expenses. METHODS We evaluate data presented in the literature and aim to give interpretations possibly helpful in the clinical practice. RESULTS The analysis of the endoscopic findings showed that applying a preendoscopic strategy based on age and H. pylori status in local hospitals without a specific interest in H. pylori research would have meant missing a proportion of relevant pathology: 35 of 557 (6.3%) peptic ulcers (24 duodenal and 11 gastric ulcers) and two gastric cancers (0.3%). CONCLUSIONS Although we do understand the need to increase the cost-effectiveness of endoscopy and realize that considering age and H. pylori status could help to get to this target, we conclude that similar preendoscopic screening strategies must be refined further before being adopted on a large scale.
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Ricci C, Longo R, Gioulis E, Bosco M, Pollesello P, Masutti F, Crocè LS, Paoletti S, de Bernard B, Tiribelli C, Dalla Palma L. Noninvasive in vivo quantitative assessment of fat content in human liver. J Hepatol 1997; 27:108-13. [PMID: 9252082 DOI: 10.1016/s0168-8278(97)80288-7] [Citation(s) in RCA: 236] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND/AIMS Since the introduction of ultrasonography, liver steatosis has become an increasingly frequent diagnosis. Both ultrasonography (US) and computerized tomography (CT) provide qualitative rather than quantitative assessment of fatty infiltration. The objective of this study was to develop a noninvasive method for the quantification of the hepatic fat content in vivo. A test object containing solutions with CT scan density (CTD) similar to normal liver ("liver-equivalent") or "fat-equivalent material" in variable proportions was prepared to measure patients with variable degrees of steatosis in vivo. RESULTS A linear correlation (r=0.99, p<0.001) linked CTD and the increasing percentage of fat-equivalent material. A CTD calibration curve was derived as a reference for the in vivo determinations. In 29 consecutive patients with steatosis diagnosed by histology, CTD was linearly correlated (r=0.83, p<0.001) with the hepatic fat content (HFC) expressed as percent of the whole liver, obtained by a computerized histomorphometric analysis. Based on the calibration curve obtained in 29 subjects who underwent liver biopsy, 38 additional consecutive steatotic patients were examined and the degree of hepatic fat content was calculated. The HFC was linearly correlated (r=-0.86, p<0.001) with the liver-to-spleen ratio. CONCLUSIONS We conclude that the use of test objects allows an accurate and reproducible noninvasive quantitative assessment of hepatic fat infiltration in humans. This technique may prove useful in the evaluation of the natural course and treatment of hepatic steatosis as well as in the assessment of donor livers prior to transplantation.
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Ciabattoni N, Badoino C, Durante V, Rota F, Perata O, Calvi G, Ricci C, Ciabattoni M. [An uncommon complication: cryptorchidism in an adult]. MINERVA CHIR 1997; 52:663-6. [PMID: 9297159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This unusual pathology has not been described in the medical literature of the last ten years. A 39-year-old patient, affected by unilateral cryptorchidism, on the right side, and congenital inguinal hernia, reached the operating theatre suffering from occlusive intestinal syndrome, due to a clogged hernial sac. This clog was caused by a retracting testicle which in turn stopped the ileal ansa from slipping back in to the peritoneum. Through this case we can underline the excursus of such pathology, which isn't very frequent in the adult but can, nevertheless create a fairly serious pathology, often leading to neoplan.
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Venuta F, De Giacomo T, Rendina EA, Trentino P, Della Rocca G, Ricci C. Double stents for carcinoma of the esophagus invading the airway. Ann Thorac Surg 1997; 63:1515-6. [PMID: 9146372 DOI: 10.1016/s0003-4975(97)82747-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Sponza M, Fabris B, Bertolotto M, Ricci C, Armini L. [Role of Doppler color ultrasonography and of flowmetric analysis in the diagnosis and follow-up of Grave's disease]. LA RADIOLOGIA MEDICA 1997; 93:405-9. [PMID: 9244919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Hyperthyroidism in Graves' disease is caused by the presence of circulating autoantibodies to the THS receptors on the thyroid cells. Thyroid-suppression therapy prevents hormone production directly, without affecting the pathogenetic process. We performed color Doppler US of the thyroid gland and pulsed Doppler analysis of thyroid artery flow in 21 patients with Graves' disease before and during medical treatment. US results were compared with those of a control group of 40 healthy subjects and correlated with the values of thyroid hormones, TSH, and thyroid microsomal and thyroglobulin antibodies. The thyroid gland was hypovascularized in the control group. Pulsed Doppler examination of the thyroid arteries exhibited peak systolic velocity of PSV 20 +/- 4 cm/s, diastolic velocity of 8 +/- 1 cm/s, and resistive index of 0.60 +/- 0.04. The thyroid gland of Graves' disease patients was hypervascularized. Pulsed Doppler examination of the thyroid arteries exhibited peak systolic velocity (PSV = 51 +/- 12 cm/s), end diastolic velocity (VD = 15 +/- 4 cm/s), and resistive index (RI = 0.71 +/- 0.04) significantly higher than in normal subjects (p < 0.001). Circulating thyroid hormones and flow parameters normalized after 6-8 months of medical therapy (PSV = 20 +/- 6 cm/s, VD = 9 +/- 3 cm/s, RI = 0.58 +/- 0.07). Conversely, the color Doppler patterns normalized only in a patient with normal TSH and antibodies. Sampling of the thyroid arteries proved more repeatable than sampling of parenchymal vessels.
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Venuta F, Rendina EA, Pescarmona EO, De Giacomo T, Vizza D, Flaishman I, Ricci C. Occult lung cancer in patients with bullous emphysema. Thorax 1997; 52:289-90. [PMID: 9093350 PMCID: PMC1758506 DOI: 10.1136/thx.52.3.289] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The incidence of lung cancer is increased in patients with bullous emphysema. METHODS A series of 95 patients undergoing excision of bullous lung tissue was reviewed to determine the incidence and long term outcome of occult carcinoma present in the resected material. RESULTS Four patients (4.2%) had peripheral foci of large cell carcinoma in the resection specimen (three bullectomies and one lobectomy). CONCLUSIONS Resected bullous lung tissue should be carefully examined for areas of bronchogenic carcinoma. The results of incidental complete excision are favourable.
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Venuta F, Rendina EA, Pescarmona EO, de Giacomo T, Flaishman I, Guarino E, Ricci C. Ambulatory mediastinal biopsy for hematologic malignancies. Eur J Cardiothorac Surg 1997; 11:218-21. [PMID: 9080146 DOI: 10.1016/s1010-7940(96)01055-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE We retrospectively evaluated our experience with outpatient surgical biopsy of mediastinal lesions in patients with hematologic malignancies, its cost-effectiveness and ability to allow diagnosis. METHODS Eighty patients underwent outpatient surgical biopsy of mediastinal lesions related to hematologic malignancies (50 cervical mediastinoscopies, 24 anterior mediastinotomies and six video-assisted thoracoscopies). Eight patients had a superior vena cava syndrome, five had lesions residuing or relapsing after chemo-radiotherapy and six and had been treated with steroids before diagnosis; in five cases the biopsy had been previously performed at other hospitals without achieving a positive diagnosis. RESULTS Ambulatory mediastinal biopsy allowed diagnosis in all cases. Fifty-one patients had Hodgkin disease, 28 had non-Hodgkin lymphoma and one had chronic lymphatic leukemia. There was no operative mortality. Complications were: pneumothorax and bleeding during mediastinoscopy and wound infection after anterior mediastinotomy. CONCLUSIONS Mediastinal biopsy can be safely performed on an outpatient basis in selected patients with mediastinal involvement due to hematologic malignancies. Costs were markedly reduced with respect to in-hospital procedures.
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MESH Headings
- Adolescent
- Adult
- Aged
- Ambulatory Surgical Procedures/economics
- Biopsy/economics
- Child
- Cost-Benefit Analysis
- Female
- Hodgkin Disease/pathology
- Hodgkin Disease/therapy
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Lymph Nodes/pathology
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, Non-Hodgkin/therapy
- Male
- Mediastinal Neoplasms/pathology
- Middle Aged
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/therapy
- Retrospective Studies
- Thoracoscopy/economics
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Venuta F, Rendina EA, Pescarmona E, Francioni F, Fazi P, Spadea A, Ricci C. Salvage lung resection for massive hemoptysis after resolution of pulmonary aspergillosis in a patient with acute leukemia. SCAND CARDIOVASC J 1997; 31:51-3. [PMID: 9171149 DOI: 10.3109/14017439709058069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A 58-year-old woman with acute myelogenous leukemia in complete remission underwent successful pulmonary resection for massive hemoptysis occurring after resolution of pulmonary aspergillosis. Despite the fact that the role of surgery in the treatment of pulmonary mycosis in immunocompromised hosts is still to be clearly defined, emergency lung resections can be successfully performed in this group of patients with almost immediate recovery of stable clinical parameters. Brisk recovery can reduce overall morbidity and mortality and allow for early resumption of any necessary treatment for underlying disease.
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