Incisional hernioplasty with a 'flower' polypropylene prosthesis.
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Hernia, Ventral↗
Biomedical subjects
A Chirico
Publications and source records attributed to A Chirico.
[Rational and mini-invasive approach to the therapy in varicose syndrome: the C.H.I.V.A. treatment].
The principles of the C.H.I.V.A. (Ambulatory conservative and haemodynamic therapy of venous insufficiency) procedure are reported. According to the Authors a careful haemodynamic evaluation of the venous system strictly correlates to the clinical and functional results. In their experience, in fact, results showed no variceal recurrence and a very low rate of complications. Therefore, the C.H.I.V.A. procedure is recommended for most of the patients with lower limb varices.
Adult↗
Technetium-99m-MRP20, a potential brain perfusion agent: in vivo biodistribution and SPECT studies in normal male volunteers.
The lipophilic neutral complex [99mTc][TcO(MRP20)] [MRP20 is (N-(2(1H pyrolylmethyl]N'-(4-pentene-3-one-2)ethane-1,2-diamine)] is known to cross the blood-brain barrier in non-primate animals. We report here its in vivo biodistribution, radiation dosimetry, and single-photon emission computed tomography (SPECT) characteristics in man. Following i.v. administration of 15-25 mCi of the tracer, the maximum uptake of activity in the brain peaked at 1 min p.i. Fifteen minutes p.i., the percentage retained in the brain was 5.2 +/- 1.6, which remained fairly constant over 24 hr. Blood clearance was relatively slow with an apparent affinity of the compound for the cellular fraction of the blood, however, soft-tissue and facial activity cleared at a rate four times faster than that of the brain. SPECT images obtained at 15 min, 1 hr, 3 hr, 7 hr, and 24 hr p.i. showed no redistribution of the tracer within the brain. The dosimetry is favorable for administration of 25-30 mCi of MRP20. Our results indicate that this compound is rapidly extracted and retained by the brain and may be used for SPECT imaging of regional blood flow.
Adult↗
Perineal colostomy and electrostimulated gracilis "neosphincter" after abdomino-perineal resection of the colon and anorectum: a surgical experience and follow-up study in 47 cases.
A series of 47 patients undergoing abdomino-perineal resection of the distal colon and anorectum and construction of a continent perineal colostomy using electrostimulated gracilis muscle is described. External and implanted pulse generators have both been used. An analysis of complications and oncological data are reported. There was no operative mortality. The incidence of complications, divided into three classes, mild (62%), moderate (27%) and severe (11%), has not significantly altered the functional results, with the exception of early ischaemia of the colonic stump in two cases. During the first 22 cases, no preoperative oncological staging was performed. In the last 23 patients endorectal ultrasonography and CT scanning were carried out. Functional results were evaluated by electromanometry, electromyostimulation and dynamic defaecography. Clinical data assessed postoperatively showed good function in 65% of cases, fair in 22.5% and poor in 12.5%. The quality of life in 15 patients with a perineal colostomy and electrostimulated gracilis was significantly better than in 15 patients having an abdomino-perineal resection without gracilis plastic reconstruction.
Adult↗
[Hepatic metastases of colorectal carcinoma. Case reports].
Authors report their clinical experience concerning liver metastases from colorectal cancer. 21 (26%) out of 87 patients observed between 1977 and 1988, underwent hepatic resection. In this group the recorded operative mortality was 4.7% and the postoperative follow-up showed a survival rate of 27% five years after hepatic surgery. Hepatic resection should be considered as the most effective treatment for liver metastases from large bowel cancer. Unfortunately only few patients are suitable for surgery. Alternative treatments for unresectable hepatic recurrences of colorectal cancer still remain a most major problem.
Aged↗
Construction of a continent perineal colostomy by using electrostimulated gracilis muscles after abdominoperineal resection: personal technique and experience with 32 cases.
A series of 32 patients operated on for rectal carcinoma is reported. A new technique by using the gracilis muscles to reconstruct a functional anal sphincter after abdominoperineal resection was performed. No operative mortality was recorded. Functionality of the new sphincter was guaranteed by electromyostimulation. Electrostimulation has been useful in both increasing the muscular trophic level and in improving the postoperative bio-feedback. Perineal infection was recorded in 9 patients being the most common complication although it did not compromise the functionality of the new sphincter. In one case acute colonic ischaemia was treated by resection and definitive left colostomy. 17 out of the 27 patients in which a functional follow-up was obtained, scored a "very good" continence to stool and flatus while in 6 patients occasional episodes of incontinence to liquid stool are referred. Local or distant metastases presented in 6 patients. The obtained results encourage in continuing the research with this technique in the attempt to reduce the number of patients that must pay the high price of a definitive abdominal colostomy for cure.
Adenocarcinoma↗
["Wandering spleen": preoperative diagnosis by echotomography of the abdomen (review of the literature and report of a case)].
Splenic wandering is a rare condition of upset position of spleen, due to congenital fault or to excessive looseness of the supporting apparatus of this organ. The literature reports about 180 cases thereof, few of which recognized as such before operation. Ultimate investigations, in this limited number of preoperative diagnoses, resulted angiography and hepato-splenic scintigraphy; only three times the diagnosis was correctly placed through ultra-sounds. The authors show a case, confirmed by the operative report, where the ultrasonic test allowed to place the diagnosis with certainty, and, due to a particular lot of circumstances, proved to be better than TAC.
Adult↗
Pylorus preserving pancreatoduodenectomy for gastrinoma. A case report.
A case of a young female patient affected by Zollinger-Ellison syndrome with occult gastrinoma during exploratory laparotomy, is reported. On the basis of transhepatic portal catheterization the patient underwent pylorus preserving pancreatoduodenectomy according to Longmire-Traverso. A malignant gastrinoma of the duodenal wall, 2 mm in diameter, was observed on the operative specimen in the suspected gastrinogenic area. The procedure led to complete clinical recovery of the patient who did not respond to the medical treatment of the ulcer. The prognosis was good with oncologic radicality of surgery confirmed at follow-up and excellent digestive function.
Adult↗
Continuous intravascular monitoring of pO2 and pCO2. A comparative in vitro-in vivo study.
Two electrodes placed at the tip of catheters for in vivo determinations of PCO2 and PO2 respectively, were tested in dogs. Results were satisfactory when compared to a highly accurate reference method, correlation coefficients were close to 1 (P less than 10(-9)). Means of the differences were respectively --1.74 +/- 1.14 toor for the PO2 probe (P less than 0.01) and --1.62 +/- 0.72 torr for the PCO2 sensor (P less than 0.0001). While no drift was detected in the PCO2 electrode, that of the PO2 was significant but negligible compared to the variability of measurements. Thus, for PCO2 values between 20 and 85 torr, and PO2 values between 20 and 140 torr, in vivo monitoring is sufficiently reliable for clinical use.
Animals↗
In vivo measurements of oxyhaemoglobin saturation by a fiberoptic catheter. The effects of variations in pH and haematocrit.
The development of plastic fiberoptic catheters, cheaper and less fragile than glass ones, has enabled the more widespread use of oxyhaemoglobin saturation (SO2) monitoring. They allow direct determinations of SO2 to be made, using reflection spectrophotometry. The purpose of the present work was to evaluate the accuracy of SO2 measurements as provided by these catheters. The studies were performed in dogs, with large variations of SO2, acid-base balance and haematocrit levels.
Acidosis↗
[Recurrent biliary calculi].
The Authors report two cases of recurrent bile duct stones and discuss about the diagnosis and treatment of this infrequent disease. Although diagnostic and management procedures are similar to those commonly used in all types of biliary stones, therapeutical options may be different in relation to the different clinical pictures. The Authors strongly suggest that bilioenteric anastomosis and endoscopic sphincterotomy are the best procedures to assure a correct and definitive treatment of recurrent biliary stones. However, the adoption of different diagnostic and therapeutic approaches, rather than univocal schemes, is recommended.
Adult↗