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743 results on '"Castello, G."'

121. Laparoscopic pancreaticoduodenectomy for tumors of the head of pancreas; 10 cases for a single center experience.

Author

CARUSO, F., ALESSANDRI, G., CESANA, G., CASTELLO, G., UCCELLI, M., CICCARESE, F., GIORGI, R., VILLA, R., SCOTTO, B., and OLMI, S.

Abstract

OBJECTIVE: The tumors of the head of the pancreas are one of the leading causes of cancer-related death in Western countries. The current gold standard for these tumors is a Whipple procedure. This procedure did not change in its surgical steps since when it was initially introduced in 1935. More recently, a laparoscopic approach with similar outcomes has been described. The aim of this paper is to describe the laparoscopic surgical technique performed in our unit, reporting single center postoperative outcomes. PATIENTS AND METHODS: From the 1st January 2013 to the 31st December 2015 a database was created. Data about patients who underwent a laparoscopic pancreaticoduodenectomy (LPD) were collected prospectively. All patients were preoperatively assessed with blood samples, tumor markers, CT chest abdomen and pelvis and/or MRI pancreas. Only patients with specific characteristics were considered eligible for an LPD: performance status 0, body mass index (BMI) less than 30 kg/m2, a small neoplastic lesion (< 3.5 cm) confined into the pancreas, the absence of infiltrated organs and/or blood vessels (T1 or T2). Postoperative data and complications were recorded and described according to the Clavien-Dindo classification and the international study group of pancreatic surgery definitions. RESULTS: In a time interval of 36 months, 31 patients with an initially considered resectable pancreatic cancer were referred. 11 patients were found to have metastasis during the preoperative workout. Only 10 patients were considered eligible for a LPD. Six of them were men (60%). The mean BMI was 25.01 kg/m2 (19.6-29.8). 5 patients, who underwent to LPD did not have any comorbidities. An overall 50% of all patients were jaundice at the time of diagnosis with a mean bilirubin level of 181.3 μmol/L (119.7-307.8). All patients with a direct bilirubin greater than 250 μmol/L underwent a preoperative percutaneous biliary drainage. In the majority of the LPD performed (50%), the histology reported a pancreatic adenocarcinoma. Other postoperative histology described were: IPMN (20%), ampullar neoplasia (20%) and neuroendocrine tumor (10%). Neo-adjuvant chemotherapy was never considered indicated. The reported postoperative complications were: 1 anastomotic bleeding, 2 pancreatic fistula, 1 infected intra-abdominal collection and 1 delay gastric emptying. The pancreatic fistulas were considered grade A and grade B. One fatality after LPD occurred because of an uncontrollable, diffuse severe hemorrhagic gastritis associated with a GJ anastomosis bleeding in the POD 25. The mean hospital stay was 12.3 days (8-25). The mean operative time was 224 min (170-310). There were no intraoperative complications. The main intraoperative blood loss was 220 ml (180-400) and intraoperative blood transfusions were not required. The resection margins were negative (R0) in 100% of cases and the mean lymph nodes harvested were 24 (18-40). The LPD is still a not common practice. Our results are comparable with those reported in literature about the open technique. These remarkable surgical outcomes are probably related to the extremely careful preoperative patient selection performed. The indication for a laparoscopic vs. an open pancreaticoduodenectomy was based on a CT scan pancreas performed less than 30 days before the planned date of surgery and a careful preoperative assessment. A low complication rate and a relative short stay in hospital were associated to a good quality of life in the early postoperative period and an early referral for postoperative chemotherapy. Good clinical outcomes were associated with outstanding oncological results. CONCLUSIONS: Laparoscopic pancreaticoduodenectomy is a feasible surgical procedure. Remarkable oncological and surgical outcomes can be achieved with a morbidity and mortality rate in line with the data reported by the large series of open procedures. [ABSTRACT FROM AUTHOR]

Published
2017

122. Subclavian vein stenosis following totally implantable venous access device (TIVAD) implant by percutaneous approach. Case report

Author

DI CARLO, Isidoro, Fasone, Ma, Toro, A, Castello, G, Sparatore, F, and Cordio, S.

Subjects
Male, Catheterization, Central Venous, Catheters, Indwelling, Humans, Constriction, Pathologic, Subclavian Vein, Aged
Abstract

Totally implantable venous access devices (TIVADs) are more and more used in oncologic patients. Early and late complications frequently occur with the techniques of implantation. Thrombosis is the most important and common late complication. On the opposite stenosis of the vessel is not frequently reported. The Authors report the case of a patient with subclavian vein stenosis after implantation of a TIVAD by percutaneous technique. On the basis of the published knowledges they try to explain this phenomenon and suggest an hypothesis for future works.

Published
2005

127. Il trauma del pancreas: caso clinicoi

Author

LA GRECA, Gaetano, Randazzo, V, Castello, G, Conti, P, Fasone, Ma, Politi, A, Gresta, S, Scarso, C, and Russello, Domenico

Published
2004

136. Circulating hematopoietic progenitor cells in polycythemia vera: The in vivo effect of hydroxyurea

Author

Cerruti A, Ivo Pannacciulli, D. Cavallini, Giuseppe Bogliolo, Roberto Lerza, and Castello G

Subjects
Male, medicine.medical_specialty, Myeloid, Clone (cell biology), Cell Count, Colony-Forming Units Assay, Hydroxycarbamide, Polycythemia vera, In vivo, hemic and lymphatic diseases, Internal medicine, medicine, Humans, Hydroxyurea, Progenitor cell, Polycythemia Vera, Aged, Hematology, business.industry, General Medicine, Middle Aged, Hematopoietic Stem Cells, medicine.disease, medicine.anatomical_structure, Endocrinology, Stem cell, business, Follow-Up Studies, circulatory and respiratory physiology, medicine.drug
Abstract

The in vivo effects of hydroxyurea (HU) on circulating erythroid (BFU-E) and granulocyte-macrophage progenitors (CFU-GM) in patients with polycythemia vera (PV) have been evaluated. HU induced a strong decrease of both BFU-E and CFU-GM in the first month of treatment. During the following 4 months of treatment the level of circulating progenitors remained at very low values, until the end of the period of observation. HU activity involved both erythroid and myeloid committed progenitors and both erythropoietin-stimulated (normal) and endogenous (derived from the abnormal PV clone) BFU-E.

Published
1995

141. Assessment of genetic instability in melanocytic skin lesions through microsatellite analysis of benign nevi, dysplastic nevi, primary melano-mas along with their metastases

Author

Palmieri G, Ascierto PA, Cossu A, Colombino M, Casula M, Botti G, Lissia A, Tanda F, and Castello G.

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, nutritional and metabolic diseases, neoplasms, digestive system diseases
Abstract

Microsatellite instability (MSI) is caused by replication errors due to deficient DNA mismatch repair and has been associated with tumour progression in different types of cancer. Controversial results have been provided about both frequency and significance of MSI in malignant melanoma (MM). In this study, time of onset and relative incidence of MSI were determined during the progression of melanocytic tumours, starting from benign melanocytic nevi. MSI was studied at 13 loci containing single-, di-, or trinucleotide repeat sequences and mapping to five different chromosomal locations. Tumours were classified as low-frequency (L-MSI+) or high-frequency (H-MSI+) MSI, when one or at least two marker loci (respectively) displayed mutant alleles in tumour DNA compared to corresponding normal tissue DNA. None of the 8 melanocytic nevi showed MSI, whereas moderate frequency of H-MSI was detected in dysplastic nevi (1/11; 9%) and primary melanomas (6/56; 11%). The incidence of MSI was increased in melanoma metastases from the same patients (H-MSI: 9/42; 21%). In contrast to previously reported data showing higher rates of MSI in melanoma, genetic instability seems to be present in a minority of MM lesions. However, our findings are consistent with the hypothesis that MSI may be sequentially induced during malignant evolution, contributing to the progression of a subset of melanocytic tumours.

Published
2003

144. The in vitro and in vivo effect of recombinant interferon α-2a on circulating haemopoietic progenitors in polycythaemia vera

Author

Cerruti A, Castello G, Roberto Lerza, D. Cavallini, Ivo Pannacciulli, and Giuseppe Bogliolo

Subjects
Male, Polycythaemia, Alpha interferon, Spleen, Interferon alpha-2, Pharmacology, Myeloproliferative Disorders, Polycythemia vera, In vivo, medicine, Humans, Progenitor cell, Polycythemia Vera, Erythroid Precursor Cells, Aged, business.industry, Macrophages, Interferon-alpha, Hematology, Middle Aged, Hematopoietic Stem Cells, medicine.disease, Recombinant Proteins, medicine.anatomical_structure, Immunology, business, Granulocytes
Abstract

In four patients with polycythaemia vera (PV) who received interferon alpha (IFN-alpha) (3 MU subcutaneously three times a week) for 5 months, peripheral blood levels of granulocyte-macrophage colony-forming units and erythroid burst-forming units were assessed monthly. Circulating progenitors significantly decreased throughout the treatment period. Moreover, we observed an inhibitory activity of IFN-alpha on haemopoietic progenitor cells (HPC) from patients with PV in vitro. The data presented confirm previous research which has shown an inhibitory effect of IFN-alpha on HPC from patients with myeloproliferative disorders. Significant improvement in the patients' clinical and haematological conditions should encourage larger studies on IFN-alpha administration in PV patients.

Published
1994

147. Investigation on elastomer-silica interactions by inverse gas chromatography and image analysis aided transmission electron microscopy

Author

Castellano M., Falqui L., Costa G., Turturro A., Valenti B., and Castello G.

Abstract

A study on the interactions between silica and elastomers typically used in tire tread production has been carried out by inverse gas chromatography (IGC) and image analysis aided transmission electron microscopy (TEM/AIA). IGC at infinite dilution has been performed using precipitated silica as the stationary phase, to determine its surface properties and to calculate the adsorption free energy and enthalpy of low molecular weight analogues of elastomers, used as the eluates. Vulcanized samples based on different matrices employed in tire formulations, i.e. natural rubber (NR), butadiene rubber (BR), styrene-butadiene rubber (SBR) have been investigated by TEM/AIA to determine the dispersion of the filler within the matrix as well as to achieve quantitative information on aggregate size and shape distribution of silica and, consequently, on the polymer-filler interactions. A comparison between thermodynamic predictions deduced by IGC and the results from morphological analysis concerning filled compounds shows a very satisfactory agreement.

Published
2002

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