Biomedical subjects
Publications and source records attributed to A Manganelli.
The Authors briefly report the data obtained from a study of the blood supply to colonic flexures. In spite of many Authors' different opinions, colonic flexures are adequately supplied by the same colonic arteries through secondary vessels as well as by the blood flow of other vascular regions.
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To eliminate the discomfort caused by surgical methods and the risks involved using the trocar, for 1 year we have been using a new technique for insertion of peritoneal catheters (PC). We devised a steel instrument, vaguely resembling a rhinoscope, composed of two semicones. The handles are connected by a screw to permit dilatation of the semicones. After local anesthesia, an introducer needle is inserted into the peritoneal cavity. A guide-wire is passed through the needle which is then withdrawn and our instrument is placed around the guide and gently pushed into the peritoneal cavity. The guide is now removed and squeezing the handles of the instrument we introduce the PC up to 2 cm beyond the first Dacron cuff. When the catheter is in place, the instrument is removed and a subcutaneous tunnel may be made. We have used this method for 25 patients. 14 were new cases while 11 underwent PC repositioning. For all patients this new method proved to be excellent with practically no leakage and PC were utilized immediately or after only 24 h. We emphasize the brief time for PC insertion, the minimum discomfort and the simplicity of the technique.
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A case of renovascular hypertension caused by a dissecting aneurysm of the main right renal artery owing to a subadventitial angioma is described. The right kidney was not functioning but, nevertheless, an aortorenal bypass was done and function of the kidney was recovered. Although the hypertension was controlled for 6 months it recurred. A nephrectomy was performed and the hypertension was cured.
Peritoneal dialysis in acute and chronic renal failure has been greatly facilitated by the advent of Tenckhoff indwelling peritoneal catheters and by strict control of peritoneal infections. A number of reports on long-term treatment have been published. A simple device has been developed and tested for regular peritoneal dialysis in the hospital and in the home, in order to accelerate the time required. Employing a 'single needle apparatus', a rotary pump and a themostatic heating unit, it is possible to carry out a very efficacious peritoneal dialysis, similar to the 'continuous peritoneal dialysis'. The purpose of this paper is to discuss its use and its advantages in comparison with classic procedures.
A case of alkaptonuria with ochronosis is described. It is suggested that such cases are not so much rare as unobserved. Their aetiology is to be sought in a metabolic error, though the pathogenesis is not clear. The syndrome is of interest because ochronosis, wich is the articular manifestation, is one of the few rheumatological affections with a certain aetiology. The case described is unusual on account of the presence of monoclonal gammopathy. Since the presence of myeloma and macroglobulinaemia could be excluded, an immunological relation was sought between the alkaptonuria and the particular serological picture.
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