Acute hepatic failure in pregnancy.

Severe liver dysfunction in late pregnancy is an unusual but dramatic event because it can progress very rapidly to fulminating disease and also because two lives, that of the mother and foetus, are involved. We report a descriptive study of a pregnant woman presenting with severe liver dysfunction.

Liver transplantation for the treatment of moderately or well-differentiated hepatocellular carcinoma.

Objective: To determine the long-term results of liver transplantation for well- or moderately differentiated hepatocellular carcinoma (HCC).

Summary Background Data: HCC patient selection for liver transplantation remains controversial, and deciding exclusively on the strength of criteria such as number and size of nodules appears prognostically inaccurate.

Methods: Since 1991, preoperative tumor grading has been used at our center to establish whether a patient with HCC is fit for transplantation.

Health-related quality of life after restorative proctocolectomy for ulcerative colitis: long-term results.

Restorative proctocolectomy (RPC) is the favorite operation for ulcerative colitis, but it may influence health-related quality of life (HRQL). Our aims were to determine the long-term HRQL of patients and its modifications after a 5-year follow-up and to identify any risk factor for a worse outcome. We enrolled 36 patients submitted to RPC (mean follow-up 8.

Adjuvant chemotherapy for transplanted hepatocellular carcinoma patients: impact on survival or HCV recurrence timing.

Introduction: Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide. In the Western world the current epidemic of cirrhosis due to the hepatitis C virus (HCV) is increasing the number of new cases. Liver transplantation (OLTx) represents a radical treatment for HCC and the underlying cirrhosis.

Liver transplantation for the management of hepatoblastoma.

Introduction: Hepatoblastoma (HEP) is the most frequent liver malignancy occurring in childhood. Surgical resection currently represents the gold standard for treatment. In patients with initially unresectable tumors, chemotherapy may induce remarkable reductions in size.

The critical issue of hepatocellular carcinoma prognostic classification: which is the best tool available?

Background/aims: Prognosis assessment in patients with hepatocellular carcinoma (HCC) remains controversial. The most widely used HCC prognostic tool is the Okuda classification, but new staging systems (Cancer of the Liver Italian Program score, Chinese University Prognostic Index, French classification and Barcelona Clinic Liver Cancer, BCLC, staging) have been recently described. We investigated the value of known prognostic systems in the particular setting of a surgically oriented Liver Unit where 187 HCC Italian patients were mainly treated with radical therapies (resection and percutaneous ablation).

Multimodal approach and its impact on survival for patients with hepatocellular carcinoma.

Background: There are few studies evaluating the prognostic impact on survival of treatment strategy in patients with hepatocellular carcinoma (HCC). The aim of this study was to analyse whether a multimodal approach, that represents a synergic association of different therapeutic procedures, may improve survival of patients with HCC.

Patients And Methods: Two hundred and fourteen patients with HCC were enrolled in the study.

Cataract surgery as a risk factor for retinal detachment in very highly myopic eyes.

Purpose: To evaluate the incidence of retinal detachment (RD) after cataract surgery performed by phacoemulsification in very highly myopic eyes.

Design: Retrospective, paired-eye, case-control trial.

Participants And Intervention: We assessed the development of RD in 930 eyes from 930 subjects (mean age = 62.

Anecortave acetate as monotherapy for treatment of subfoveal neovascularization in age-related macular degeneration: twelve-month clinical outcomes.

Purpose: To evaluate safety and efficacy of the angiostatic agent anecortave acetate, compared with a placebo, for treatment of subfoveal choroidal neovascularization (CNV).

Design: Ongoing masked, randomized, placebo-controlled, parallel evaluation of anecortave acetate (30 mg, 15 mg, and 3 mg) versus a placebo.

Participants: There were 128 eyes of 128 patients with subfoveal CNV secondary to age-related macular degeneration who were enrolled and treated, with 80% (102/128) of eyes presenting with predominantly classic lesions at baseline.

Bioartificial liver support. Review and personal experience.

End-stage liver disease is treated successfully by liver transplantation. In spite of the recent advances in transplantation techniques, donor organ shortage remains a serious problem. Conditions such as fulminant hepatic failure are still burdened by a high mortality rate.

Severe gastrointestinal bleeding in Crohn's disease.

Introduction: Acute gastrointestinal bleeding is rare in Crohn's disease.

Methods: We characterized the clinical features and course of such hemorrhage in patients seen at our institution from 1992 to 2000.

Results: Five patients had gastrointestinal bleeding during Crohn's disease.

Perfluorocarbon liquid utilization in primary vitrectomy repair of retinal detachment with multiple breaks.

Purpose: To evaluate the efficacy of pars plana vitrectomy in conjunction with intraoperative perfluoro-n-octane (PFO) use as initial treatment of retinal detachment (RD) with multiple breaks located at various distances from the ora serrata.

Methods: Twenty-two consecutive eyes (15 phakic, 2 aphakic, and 5 pseudophakic) presenting with RD with multiple breaks and tears underwent primary pars plana vitrectomy, PFO retinal reattachment, transcleral cryopexy or endolaser treatment of breaks, PFO/air exchange, and final injection of 18% perfluoropropane (C3F8). Scleral buckles were not used.

CT characteristics of intraocular perfluoro-N-octane.

Perfluoro-N-octane (PFO) is a heavy liquid that is used as an aid for complicated retinal surgical procedures. Although PFO is usually removed intraoperatively, the radiographic appearance of retained PFO may mimic an intraocular foreign body or vitreous hemorrhage. As the use of PFO in retinal procedures has become more widespread, recognition of its imaging appearance has become important in the differential diagnosis of intraocular foreign body and ocular trauma.

A rare surgical complication of Crohn's diseases: free peritoneal perforation.

Background: Free peritoneal perforation is a rare complication of Crohn's disease.

Methods: We evaluated the incidence of free peritoneal perforation among 208 patients with Crohn's disease surgically treated in the period 1992-2000.

Results: Five patients (2.

[Is it possible to improve survival in patients with Klatskin tumors?].

Background: This retrospective study was undertaken to evaluate if a high resectability rate could improve the long-term outcome of patients with proximal bile duct cancer.

Methods: Between 1985 and 2001, 50 patients (34 males and 16 females) with proximal bile duct cancer were treated. The tumor site were classified according to Bismuth-Corlette's classification: 9 lesions (18%) were Bismuth type I, 23 lesions (46%) type II, 12 lesions (24%) Type IIIa, 5 lesions (10%) type IIIb and only 1 resected tumor (2%) was type IV.

Use of the Migraine Disability Assessment Questionnaire in children and adolescents with headache: an Italian pilot study.

Objectives: To determine the suitability of the Migraine Disability Assessment (MIDAS) Questionnaire for assessing disability in children and adolescents with headache and to obtain preliminary information about disability in different primary headaches.

Background: During the last decade, researchers have begun to employ standardized methodologies to investigate the global impact of primary headaches. Disease-specific instruments have been developed to measure headache-related disability.

A multicenter pilot prospective study comparing Celsior and University of Wisconsin preserving solutions for use in liver transplantation.

Primary dysfunction (PDF) still occurs after orthotopic liver transplantation (OLT). Celsior solution (CS) might offer some advantages over the conventional University of Wisconsin (UW) solution for organ preservation, but to date, this has not been prospectively evaluated in the context of OLT. In this prospective, randomized, multicenter, pilot study, 215 potential liver donors were enrolled and randomized.

Ablation of vitreous tissue with a high repetition rate erbium:YAG laser.

Purpose: To quantify erbium (Er):YAG laser ablation of vitreous in relation to different pulse repetition rates < or = 200 Hz, in order to examine the feasibility of laser for removal of vitreous gel (photovitrectomy) in clinically acceptable times.

Methods: Fresh porcine vitreous samples and saline controls were ablated in air with an Er:YAG laser connected to a sapphire fiber at pulse energies between 1.0 and 21.

Effects of 6-12 months of esomeprazole treatment on the gastric mucosa.

Objective: The aim of this study was to determine the effect of 6-12 months of treatment with esomeprazole on the histopathology of the gastric mucosa.

Methods: Two identically designed, randomized, placebo-controlled trials of esomeprazole 40, 20, or 10 mg daily for up to 6 months, as well as a noncomparative, multicenter trial of esomeprazole 40 mg daily for up to 12 months, were conducted in 1326 patients with healed erosive esophagitis (1294 negative for Helicobacter pylori [H. pylori]).

Treatment of chronic daily headache with medication overuse.

Clinicians long have suspected that symptomatic medications taken by those with headache can cause rebound or drug-induced headaches if overused. This problem has been considered in the classification of headache disorders made by the International Headache Society. Patients who overuse medication must be withdrawn before their headache can be treated effectively.

Quality of life and disability in primary chronic daily headaches.

We assessed functional disability and health-related quality of life (HRQOL) in Italian patients suffering from chronic migraine and medication overuse (150 subjects) or chronic cluster headache (22 subjects). We used the validated Italian versions of the Migraine Disability Assessment Score (MIDAS) and of the Short Form 36 (SF-36). Patients with both conditions were characterised by significantly lower scores on most SF-36 scales than Italian normative data (Student's t test with Bonferroni correction).