Postoperative anal stenoses with Ligasure hemorrhoidectomy.
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Biomedical subjects
Publications and source records attributed to D Venditti.
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Following stoma construction, parastomal hernia is the most frequent complication. Many surgical techniques have been postulated for these patients, and prosthetic surgery represents the first-choice treatment. We report our personal experience with 8 cases of parastomal hernia in patients submitted to abdominal perineal resection according to Miles, for carcinoma of the lower rectum. Polypropylene mesh was shaped according to the size of the fascial defects, characterized by a romboid incision about 4 cm in length. The mesh was placed in suprafascial position, after suturing the fascial tear. One case of wound infection occurred and, to date, none of the patients have presented with recurrence after a 3-year follow-up. In conclusion, the use of polypropylene mesh for parastomal hernia repair represents a safe and successful technique.
Three soils contaminated by heavy metals (HMs) and aliphatic hydrocarbons originating from different industrial sources were characterized in a multidisciplinary study combining chemical, physical (Part A), and mineralogical (Part B) approaches to define history, environmental risks, and remediation feasibility. These were an agricultural soil located nearby a Zn/Pb smelter and two soils from a steel metallurgical (siderurgy) waste land. High Pb and Zn contents were reported for all, and high Cr, Cd, and aliphatic hydrocarbons were present in different combinations in two out of three soils. Carbonate matrixes more strongly cemented fine particles in the agricultural soil than in both siderurgical ones, but buffering capacities were stronger in the latter. After the disruption of these cements by ultrasounds, HM were concentrated in the <50-microm fraction of the agricultural and of one siderurgical soil. Sequential extractions indicated for all the soils a preferential association of HM with carbonates, Fe-Mn oxides, organic matter, and sulfides. The stirring of one siderurgical soil with water resulted in an immediate leaching of hexavalent chromium (0.3 mg x L(-1)) involving potential ecotoxicological risks.
Three soils contaminated by industrial smelting activities previously characterized using chemical and physical approaches (Part A, Venditti et al. [2000] Arch Environ Contam Toxicol [in press]) were further investigated through a complementary mineralogical approach. X-ray diffraction allowed identification of the main mineral components: carbonates (calcite, siderite) and iron oxides (magnetite, hematite, goethite) prevailed in both siderurgical soils, and siliceous compounds were more abundant in the agricultural soil. Scanning electron microscopy coupled with energy dispersive x-ray microanalysis showed that carbonates and oxides contained low amounts of heavy metals (HMs), but the potential solubility of such species under acidic conditions associated to their abundance may result in a high mobility of associated contaminants. Microanalysis also revealed peculiar minor mineral forms (metallic nodules, alloys, ore residues) that were highly informative about the history of soil contamination. Small metal-rich particles were observed (brass, lead and zinc oxides). In such compounds, HMs showed high chemical stability and were consequently poorly mobile and toxic, but also poorly removable through chemical leaching. A risk of mechanical dispersion was suggested for these particles, particularly after the chemical and/or mechanical disruption of carbonate cements. These features allowed completion and confirmation of the conclusions achieved after chemical and physical investigations, providing accurate information about the history, environmental risks and remediation feasability of industrial soil contamination.
A duplex polymerase chain reaction (PCR) was developed for the simultaneous detection of Chlamydia pneumoniae and Mycoplasma pneumoniae. A study of 163 respiratory specimens from in-patients of the "Centre Hospitalier et Universitaire de Nancy" showed the good sensitivity of this duplex PCR allowing the detection of C. pneumoniae and M. pneumoniae from 8 and 13 patients, respectively, whereas the culture was negative for C. pneumoniae for all the samples and positive for M. pneumoniae only in 9 cases. The value of these results has been confirmed by running on the same samples specific nested PCRs for these two microorganisms that gave the same results. Thus, the proposed duplex amplification technique may facilitate the diagnosis of infection by these two agents that are difficult to isolate.
Intracellular parasites and endosymbionts are present in almost all forms of life, including bacteria. Some eukaryotic organelles are believed to be derived from ancestral endosymbionts. Parasites and symbionts show several adaptations to intracellular life. A comparative analysis of their biology suggests some general considerations involved in adapting to intracellular life and reveals a number of independently achieved strategies for the exploitation of an intracellular habitat. Symbioses mainly based on a form of syntrophy may have led to the establishment of unique physiological systems. Generally, a symbiont can be considered to be an attenuated pathogen. The combination of morphological studies, molecular phylogenetic analyses, and palaeobiological data has led to considerable improvement in the understanding of intracellular life evolution. Comparing host and symbiont phylogenies could lead to an explanation of the evolutionary history of symbiosis. These studies also provide strong evidences for the endosymbiogenesis of the eukaryotic cell. Indeed, an eubacterial origin for mitochondria and plastids is well accepted and is suggested for other organelles. The expansion of intracellular living associations is presented, with a particular emphasis on peculiar aspects and/or recent data, providing a global evaluation.
BACKGROUND: Twenty-one patients who had simple rectovaginal fistulas were treated at the Surgical Department of "Tor Vergata" University from 1992 to 1996 all of whom were at the first approach. METHODS: The fistulas were treated with complete excision of the external tract and primary closure of the internal opening with advancement of a rectal mucosal flap, distal to the origin fistulas opening. The vaginal side is left open for drainage. RESULTS: Eighteen of the twenty-one patients had good results; three patients required reoperation for recurrences; all of them had satisfactory results. CONCLUSIONS: The advancement flap technique was very useful for simple rectovaginal fistulas with any sphincter damage, and it is very well tolerated by patients.
Genomic DNA fragments encoding beta-glucosidase activity from the wild-type strain WD4 of Erwinia herbicola were cloned into Escherichia coli. Two clones containing a common fragment encoded a polypeptide of 58,000 Da. Cloned beta-glucosidase, expressed in E. coli, showed activity against natural beta-glucoside sugars except for cellobiose. An open reading frame of 1442 bp termed bglA was identified by nucleotide sequencing and it coded for a protein of 480 amino acids (M(r) 53,896) which showed significant homology with beta-glucosidases from glycosyl hydrolase family 1.
Bladder evacuation device "Urovac": comparison with the conventional most used devices. We evaluated a new technique for bladder evacuation primarily during Turp using a disposable device called Urovac. This device proved to be better for evacuation of prostatic chips than both the Ellik evacuation and Toomey syringe.
We report a case of bladder calcifications after intravescical mitomycin C in patient with recurrent superficial multifocal transitional cell carcinoma (TCC) of the bladder. The endoscopic appearance was particularly interesting since these calcifications occurred only in the areas of previous transurethral resection (TUR).
The authors propose an alternative which has been proved valid in four cases of peritoneovenous shunt with an occluded Le Veen valve for venous thrombosis implanted in cirrhotic patients with refractory ascites. After having explored the various possibilities using the vessels adjacent to the superior cava branch, the authors resolved the problem of reimplanting the valve by using an access route through the saphenous vein and inferior vena cava. Using this technique it was possible to reactivate the shunt with a marked improvement in the recurrent ascitic state and above all shunt functionality, and consequently in the clinical conditions and quality of life of these patients.
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The authors underline the efficacy of peritoneovenous shunting with LeVeen's valve in the treatment of refractory ascites in cirrhotic patients. Selection and appropriate preoperative management of patients are essential to assure good immediate and long-term results.
The Authors depict the possibility to reduce the risk of variceal bleeding with the embolization of the left gastric vein through a transhepatic or mini-laparotomic approach. Such treatment applied in 5 cases was effective: during a mean one-year follow-up no rebleeding was registered, while the stabilization of a satisfying haemodynamic state in relation to the chronic liver disease was observed.
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