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Biomedical subjects

F Brunelli

Publications and source records attributed to F Brunelli.

At least 73 records · Page 4Linked to original sources
PubMed1988

Trapeziometacarpal stabilisation in arthrosis.

The trapeziometacarpal (TM) joint is often the site of painful arthrosis, particularly in women at the onset of the fourth decade. It is generally associated with capsuloligamentous laxity of the joint or with work requiring the repetitive use of the thumb and index finger and thus work which is typically done by women. It may also be of traumatic origin following joint fracture, but this is not discussed in the present paper. The treatment of this syndrome by stabilisation of the joint is described.

Adult↗
PubMed1985

Problems in nerve lesions surgery.

An overview of the concepts on peripheral nerve regeneration and of research on the progress in this field is carried out. Problems of regeneration and factors influencing it, both improving and worsening it, are considered, especially with respect to the clinical treatment of nerve lesions. Classical techniques of repair (sutures and grafts) as well as very new methods (e.g., direct muscular neurotization) are discussed. Postoperative treatment and result evaluation are presented.

Humans↗
PubMed1985

Fractures of the hook of the hamate.

Fractures of the hook of the hamate are rare injuries. Six new cases are presented; the most usual mechanism is probably a direct blow to the area of the hook. The diagnosis, which can only be made by special roentgenographic techniques is usually missed at the acute phase. Most of the cases are diagnosed when painful non-union, fraying tendinitis of the flexor tendons to the ulnar fingers, ulnar or median nerve deficits appear. The adequate treatment is usually excision of the hook fragment.

Adult↗
PubMed1985

[Muscular elementarization in the "borderline" replantation and revascularization of the forearm].

In order to avoid the risks of local and general complications encountered in replantations after long ("critical") periods of ischemia, or in cases of severe open fractures with crushed muscles, a so-called "muscle elementarization" technique has been devised. This technique consists of removing the muscular masses which have undergone prolonged ischemia with a priority for the least important muscles. In this manner, we believe that edema and the consequent risks of compartment syndromes as well as of life threatening complications can be reduced. Functional impairment is limited as well. Eleven cases of severe crushing or critical time limit ischemia replantation have been treated in this manner without any complications.

Forearm↗
PubMed1985

Surgical treatment of actinic brachial plexus lesions: free microvascular transfer of the greater omentum.

Actinic brachial plexus lesions after mastectomy have been treated in 67 cases. Thirty-nine cases have been operated on, 31 of which by means of a free microvascular transfer of the greater omentum. Indications and contraindications of the procedure are discussed, as well as the types of anatomic-pathologic lesions that have been found, and the surgical technique that has been modified and improved over time is presented. Results indicate that free microvascular greater omentum transfer following neurolysis is currently the best method for relief of pain.

Arm↗
PubMed1984

Experimental foetal microsurgery as related to myelomeningocele.

To study this capacity of embryono-foetal tissue to regenerate without scar formation, experimental intrauterine surgery has been carried out in rabbits. This study has been performed with regard to the possibility of using intrauterine microsurgery to correct myelomeningocele in humans to avoid scar adhesion between the medulla and the growing vertebral bones and subsequent hydrocephalus. Lesions were produced in the spinal cord of rabbit foetuses, and observation after birth showed repair without scar formation. Further research is in progress to confirm these findings and to adapt this procedure to the clinical situation.

Animals↗
PubMed1984

[Surgical treatment of the tetralogy of Fallot with a single pulmonary artery].

Eleven patients with Tetralogy of Fallot and congenital or acquired absence of one pulmonary artery (PA) have been operated upon at the Department of Cardiac Surgery of Ospedali Riuniti-Bergamo-Italy. Eight children had agenesis of the left PA, one of the right PA and two had complete occlusion of the right PA after a palliative operation. Four patients had only a palliative procedure (one Blalock-Taussig, two Waterston, three PTFE shunts) with one operative death. Two patients underwent a two-staged procedure, that is an initial shunt (one Blalock and one PTFE shunt) followed by subsequent total correction. Five patients underwent primary total correction. No operative death occurred among the patients who had total correction. Right ventricular outflow reconstruction has been accomplished with an infundibular patch in one patient, an external valved conduit in two patients, and a transanular patch plus orthotopic bioprosthesis in 4 patients. One patient with a valved conduit died one year postoperatively in right heart failure caused by pulmonary hypertension. The pulmonary vascular disease was probably due to pulmonary microembolization following the severe hemolysis that lasted for twenty days in the early postoperative period. The nine surgical survivors are in good general condition with maximum follow-up of 7 years. The surgical approach either in case of palliation or in case of corrective surgery is finally discussed. In our experience TOF with unilateral absence of a PA is a congenital anomaly that can be corrected with results comparable to those of uncomplicated TOF.

Abnormalities, Multiple↗
PubMed1983

Partial selective denervation in spastic palsies (hyponeurotization).

Treating spastic palsies is a difficult problem. Hyponeurotization is a technique in which peripheral nerves are partially and selectively denervated to diminish spasm in muscles, hence reducing spasticity and tenseness so inimical to movement. Hyponeurotization can be performed in all spastic patients who are capable of cooperating. It should be avoided in cases of athetosis and brain impairment. Partial denervation is employed to reduce spasm; tenotomies, tendon lengthening, and myoectomy are employed to increase length in retracted muscles. Secondary surgery is usually required to further correct the spasm after the "adoption" phenomenon is complete. The results with hyponeurotization have been good in a high percentage of cases in which the surgery strictly adhered to basic principles.

Humans↗
PubMed1983

[Selective microsurgical denervation in spastic paralysis].

Denervation, provosed at the turn of the century and abandoned because of inconstant results, has again been taken up in principle, but with a notable change in technique. It is necessary to do a careful examination of the muscles that are to be denervated (of the median and ulnar nerves) and to determine the nature of the spasticity. The incision, longer than in the original technique, allows a better view of the median and ulnar nerves. The nerve branches to each muscle are thus easily identified, and by electric stimulation during the operation one judges how much denervation to subject the muscles to while taking into account the phenomenon of the take-over of the denervated muscles by the remaining nerve fibers. Part of the nerve branches are then sectioned under microscopic control near the muscle, taking care to cauterize the proximal stump. It may be necessary to do associated tenotomies or capsulotomies. This method gives good results if the technique and the contraindications, (athetosis, chorea and cerebral deficits) are respected. It must be emphasized that the results depend on the degree of denervation, which is hardly quantifiable, and is subject to the operator's experience.

Arm↗
PubMed1983

Slip-knot flexor tendon suture in Zone II allowing immediate mobilisation.

Immediate mobilisation after flexor tendon suture produces a conflict between the muscle force and resistance of the sutures. Sutures within the tendon after repair are weak and need contrived measures (e.g. wrist and metacarpophalangeal flexion, rubber bands etc.) to prevent dehiscence, while pull-out sutures do not allow mobilisation because of their anchorage. A new technique is presented which consists of a simple slip-knot suture which transmits the tension generated by the muscle to the distal tendon stump and its bony insertion, allowing immediate mobilisation. Results in ninety eight cases repaired by this technique during nine years are presented.

Adult↗
PubMedDate not supplied

Effect of omeprazole on interdigestive gastroduodenal motility of patients with ulcer-like dyspepsia.

BACKGROUND/AIMS: As omeprazole, an antisecretory drug, is largely used in the treatment of acid-related diseases, we investigated its effects on the interdigestive gastroduodenal motility of ulcer-like dyspepsia. METHODOLOGY: Gastroduodenal motility was recorded manometrically in 9 patients complaining of ulcer-like dyspepsia with normal gastric emptying at scintigraphy, without ulcerative lesions and H. pylori infection at endoscopy, and without diseases known to affect gut motility (group ULD), and in a group of 9 healthy subjects as control (group C). After a period sufficient to record two consecutive phases III of the migrating motor complex (MMC) in patients of group ULD, omeprazole 20 mg was infused intravenously 30 min after the end of the last duodenal phase III and the recording was continued to the next one. RESULTS: With respect to the control group, the group ULD showed a significantly longer MMC cycle duration, a frequent absence of gastric phases III and a shorter duration of duodenal phases III. Omeprazole administration in group ULD was followed after 18.9 +/- 8.5 min by a typical gastroduodenal phase III and, consequently, the duration of the omeprazole-related cycle was significantly shortened. These omeprazole-related phases III started from the stomach in nearly all cases and showed a significantly longer duration at the duodenal level with respect to the spontaneous ones. CONCLUSIONS: Patients with ulcer-like dyspepsia showed a decrease in frequency and duration of gastroduodenal phases III. The omeprazole intravenous administration induced the anticipated appearance of an apparently normal gastroduodenal phase III, probably by suppressing the inhibitory action of acid secretion.

Adult↗
PubMedDate not supplied

Study of anatomical bases of a latero-dorsal flap of the forearm preserving the radial artery.

The authors studied the dorso-lateral cutaneous branches of the radial artery in 26 forearms of fresh cadavers following injection of latex. Three to eight branches were identified, with frequent anastomoses. Extensive venous drainage was also observed. One to three cutaneous branches arose within a 3-cm region close to the radial styloid precess. This provides a basis for an island flap supplied by these branches and thus, it is possible to maintain the radial artery intact.

Aged↗
PubMedDate not supplied

Anomalous origin of the left coronary artery from the pulmonary artery. Experience with 13 cases.

The authors present their clinical and surgical experience with 13 cases of anomalous origin of the left coronary artery from the pulmonary artery. The series confirms the existence of 2 different anatomical types of this anomaly depending upon the different development of the intercoronary collateral blood-flow: the "infantile" and the "adult" types. Mitral incompetence is a frequent associated anomaly which may sometimes be the presenting clinical feature, thus masking the underlying disease. The results with different surgical techniques performed in 7 patients are discussed.

Adult↗