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F Bracci

Publications and source records attributed to F Bracci.

28 records · Page 2Linked to original sources

Sulfated bile acids in serum, bile, and urine of cirrhotic patients before and after portacaval anastomosis.

Sulfated and unsulfated bile acid composition was studied in serum and bile in 10 patients with alcoholic cirrhosis. Samples, collected before and 2 months after portacaval anastomosis, were analyzed using a gaschromatographic method. Mean total serum bile acid levels rose from 32.0 +/- 5.3 (SE) mumol/liter before to 87.4 +/- 13.3 mumol/liter after surgery (P less than 0.005). The increase in serum bile acid levels was significantly only with respect to the unsulfated fraction (22.7 +/- 3.0 mumol/liter to 67.6 +/- 8.1 mumol/liter, P less than 0.005). Thus the percent sulfation of total serum bile acid decreased from 24.6% to 19.2%. The sulfated bile acid fraction comprised mainly chenodeoxycholate both before and after surgery. Percent sulfation of individual bile acids was not modified after portacaval anastomosis. Bile acid sulfates were present in bile only in negligible amounts. The daily urinary excretion of bile acids, studied in 6 patients, increased significantly (P less than 0.05) after surgery, the increase being due only to the unsulfated compounds. Data from this study indicate that in cirrhotic patients no significant changes occur in serum with respect to sulfated bile acids after portacaval anastomosis, despite a definite increase in serum unsulfated bile acid levels. This is likely due to the lack of an efficient enterohepatic circulation of bile acid sulfates.

Adult↗

Structure of biliary phosphatidylcholine in cholesterol gallstone patients.

The fatty acid composition of biliary phosphatidylcholine was analyzed in 13 patients with radiolucent gallstones undergoing elective cholecystectomy, and in 11 normolipemic patients without gallstone undergoing abdominal surgery. The only difference in the percentage fatty acid composition between the two groups was a significantly (p less than 0.05) higher percentage arachidonic acid in the first group. This acid was exclusively located in the sn-2 position of phosphatidylcholine (PC), accounting for 13.0 +/- 4.9% in the first group and 8.2 +/- 4.9% in the second (p less than 0.05). The percentage arachidonic acid of PC was negatively correlated (p less than 0.001) with the percentage biliary chenodeoxycholate in gallstone patients, but not in controls. Explanation of these findings is, at present, only speculative.

Adult↗

[Return to the home environment and to work of the patient treated with portacaval anastomsosis].

Social and occupational reinsertion is examined with reference to a series of 137 patients subjected to side-to-side porto-cava anastomosis for portal hypertension due to cirrhosis of the liver. Postoperative occupational reinstatement was possible in a group of patients (39.42%) who had been compelled to work less on account of haemorrhages. Considering the seriousness of the operation and the long convalescence required, there was a good overall recommencement of occupational activity (73.72%). The view is expressed that continuous contact with the hospital is essential, since this will more readily ensure that the basic hygienic and dietetic rules applicable to the patient are respected. In addition, it is felt that the patient should be required to lead as normal a life as possible, in spite of his underlying liver alteration.

Adult↗

Nonfunctional preaortic paraganglioma: report of one case.

A case of nonfunctional benign preaortic paraganglioma is reported. The patient, a woman aged 50, complained of vague mesogastric pain irradiated posteriorly, occasional nausea and vomiting, related to a tender pulsatile mesogastric mass fixed to the posterior wall of the abdomen. Preoperative diagnostic examinations showed a severe anemia, a severe mechanical impairment of renal function as shown at IVP, a doubt of aortic aneurism at echography, not confirmed by selective arteriography. The mass was removed radically. The diagnosis of nature was only microscopic. Since from 15 days after surgery IVP improved significantly. At three months follow-up the patient is well with no sign of recurrence.

Female↗

Influence of portacaval anastomosis on serum and biliary unsulfated bile acid composition in patients with liver cirrhosis.

UNLABELLED: Serum and biliary unsulfated bile acids were studied using a gas chromatographic method in 8 patients before and 2 months after portacaval anastomosis. Total serum bile acids were 21.6 +/- 3.6 mumol/liter before and 68.0 +/- 8.6 mumol/liter after surgery (P less than 0.005). Cholic acid rose from 26.5 +/- 3.4% to 33.8 +/- 4.8% (P less than 0.02) of the total serum bile acids, while chenodeoxycholic acid decreased from 67.9 +/- 4.1% to 60.8 +/- 4.3% (P less than 0.05). The relative concentration of cholic and chenodeoxycholic acids in bile increased slightly but not significantly after surgery, while deoxycholate fell from 8.5 +/- 1.7% to 2.1 +/- 0.6%. CONCLUSIONS: (1) in cirrhosis the serum and biliary bile acid composition are markedly different, the cholic-chenodeoxycholic ratio being much lower in serum than in bile; (2) after portacaval anastomosis serum and biliary bile acid patterns tend to become similar; (3) percent biliary deoxycholate decreases significantly after surgery.

Adult↗

Operative morbidity after shunt surgery for portal hypertension.

The operative morbidity observed in a consecutive series of 286 patients who underwent shunt surgery for portal hypertension is reported. 149 patients out of 286 (52.1%) had a postoperative complication, which required reoperation in 11 cases (5 intestinal perforations, 2 bleeding peptic ulcers, 1 eventratio, 1 cholestasis, 1 acute pancreatitis, 1 strangulated hernia). 42 patients out of the 149 with complications died of the complication (operative mortality 14.6%). Operative morbidity and mortality appeared higher in patients operated as emergencies. Whereas elective shunts gave better results. The problem involved in preventing and treating the serious complications following shunt surgery for portal hypertension are discussed.

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