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Biomedical subjects

C Cavina

Publications and source records attributed to C Cavina.

At least 19 recordsLinked to original sources

A new autologous venous valve by intimal flap. One case report.

Various surgical techniques have been proposed for the treatment of chronic venous insufficiency of post-thrombotic recanalized deep veins of the lower limbs. The preferable method seems to be represented by intravenous valvuloplasty except for the cases affected by extensive valvular damage. For this reason some experimental autologous, heterologous and prosthetic venous valves have been proposed. Such a problem emerged for 1 patient (male, aged 78 years, right limb, leg dystrophy, multiple ulcerations at the ankle) which was selected by duplex, Doppler venous pressure index, photoplethysmography and ascending phlebography. An iliac-femoral and popliteal post-thrombotic, recanalized, decompensated venous insufficiency and one Cockett's perforator incompetence were diagnosed (CEAP classification: C6s Es As2d14 Pr). A bicuspid apparently repairable popliteal valve was detected by phlebography. A traditional intravenous valvuloplasty was planned but the valve was not found at surgical exploration. A monocuspid valve reconstruction by intimal flap vein was performed. The following results were obtained and controlled after one year: stable ulceration healing, dystrophy reduction, improvement in the quality of life, normalization of the hemodynamic parameters and of the radiological morphology of the new valve. It can be concluded that monocuspid valvular repair by intimal flap can be successfully performed in cases affected by secondary valveless deep venous insufficiency of the lower limbs.

Aged↗

Reduction mammaplasty and correction of ptosis: a personal technique.

New upper pedicle reduction mammaplasty and mastopexy techniques are presented. The surgical steps are described point by point. An analysis is made of the results obtained in 25 patients who underwent surgery between November of 1987 and November of 1988 and were examined in December of 1990 with a mean follow-up of 31.5 months. An assessment was made of the postoperative ptosis, which was minimal in 76 percent of patients. The overall assessment of breasts was satisfactory (good mammary morphology and a correct position of the nipple-areola complex). Nipple-areola complex sensitivity was unchanged in 80 percent of patients. Good-quality inframammary scars were observed in 92 percent of patients, with scar length never exceeding 4 cm. The overall complication rate was 32 percent, but only 12 percent were major complications. The technique presented is excellent when the quantity of glandular tissue to be removed is less than 400 gm, and it is not therefore recommended for gigantomasties.

Adolescent↗

Recurrent basal cell carcinoma of the back infiltrating the spine. Recurrent basal cell carcinoma.

BACKGROUND: Risk of basal cell carcinoma (BCC) recurrence appears to be related to tumor location, tumor size, treatment modality, radicalness of excision, and histologic type. Recurrences of BCC on the trunk and extremities are rare, with 97% of all recurrent lesions being located in the head and neck region. OBJECTIVE: This report concerns a man who had a BCC of the back removed with electrodesiccation and curettage in 1980 at the age of 36. In the following 10 years the patient experienced five recurrences and finally developed infiltration of the thoracic spine that precluded further attempts at radical excision of the neoplasm. METHODS AND RESULTS: The pathology of the BCC in our patient revealed a number of histologic features that have been associated with aggressive behaviour. These include an infiltrative growth pattern characterized by an irregular and acute tapered profile of the tumor cell groups and fibroblast-rich stroma, infiltrating invading tumour edges, poorly peripheral palisading, nuclear pleomorphism, and perineural invasion. CONCLUSION: Basal cell carcinomas that occur in sunlight-protected areas of the trunk of middle-aged individuals can occasionally exhibit aggressive and highly invasive features as well as a marked tendency for local uncontrollable recurrences. The prognosis for patients with this variety of BCC is poor, especially when progressive infiltration of deep tissues does not permit, as in our case, any possible further radical surgical procedure.

Back↗

Treatment of orthognathic problems related to scleroderma.

Scleroderma is a generalized disorder characterized by abnormalities of the small arteries and vasculature resulting in thickening and prominent fibrosis of the affected tissues. Its etiology remains uncertain. All connective tissue and certain internal organs, notably the gastrointestinal tract, heart, lung, and kidneys, as well as skin, are typically involved. Mandibular movement can become severely restricted when the facial skin is affected, sometimes resulting in secondary changes to both the mandible itself and the temporomandibular joint. We present 2 cases in which we improved facial aesthetics and mandibular function by surgically correcting malocclusion with a Le Fort I osteotomy and maxillary intrusion in patients with manifestations of scleroderma in the face and neck.

Adult↗

Craniopagus twins. An unsuccessful separation and a clinical review of the entity.

Craniopagus twinning is an extremely uncommon birth defect with an estimated incidence of 4-6 every 10 million births. The most complex and challenging issue is the feasibility of surgical separation, which involves not only technical but also socioethical problems and requires strict multidisciplinary cooperation between pediatricians, neuroradiologists, anesthesiologists, and plastic and neurological surgeons. The authors report a case in which separation was followed by the death of both twins and stress the importance, from the surgical and prognostic viewpoints, of the degree of vascular connections between the major dural sinuses. We propose a classification into three types according to severity.

Cerebral Angiography↗

Arthrography in the investigation of persistent pain after meniscectomy.

The authors report 62 patients in whom arthrography of the knee had been performed because of persistent pain after menisectomy. In about 60% of the cases the interval between operation and arthrography was less than 18 months. The causes of residual pain identified by arthrography were divided into meniscal and extra meniscal. The most frequent findings were remnants of pathological meniscal tissue; lesions of the anterior cruciate ligament; synovial and chondral pathology. Thirty patients were checked by arthroscopy and were subjected to further operation. In 80% of these cases the arthrographic findings corresponded exactly with the operative findings. The writers confirm that arthrography is still a valid method of investigation in patients affected by persisting pain after meniscectomy.

Adolescent↗

[Arteriography findings in vibration vascular disease of upper limbs ("vibration angiopahty") (author's transl)].

A bilateral angiographic study of the upper limbs was carried out under general anaesthesia in a group of 81 subjects--mostly (91.3%) miners--using vibrating tools. The patients' age ranged from 30 to 57 years; the time they worked as vibrating tool operators varied from 5 to 36 years; the duration of symptoms ranged from 3 months to 10 years. The mean values were 46.1, 20.9 and 3.7 years, respectively. Seventy-four subjects (91.3%) complained of Raynaud's-like phenomenon, which in 36 (44.4%) of them was elicited too, although partially, by provocative tests (cold exposure). Angiography was carried out under general anaesthesia maintained with halothane. Bilateral angiograms were available in 61 instances; in the remainder, only either right or left angiograms could be obtained. In all the subjects examined arteriographic lesions were found, mainly represented by organic stenoses and occlusions. The prevalance of such lesions was minimal at the level of the forearm arteries, and maximal at the level of the digital arteries. The 2nd finger, bilaterally, was the most frequently involved; the index finger on either side and the middle one on the right side were the most involved as to severity and extent of lesions. The 1st finger, however, was quite frequently involved too. No definite relationship between prevalance, severity and extent of arterial lesions, on one hand, and some history, clinical and functional parameters (such as age, vibrating tool usage time, smoking habit, hand arterial pattern, pulmonary silicosis, instrumental findings and Raynaud's-like phenomenon), on the other hand, could be established. As to Raynaud's-like phenomenon, it is hypothesized that such a finding could be, at least in part of cases, subsequent to the previous development of organic lesions in the digital arteries.

Adult↗