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Biomedical subjects

F D'Angelo

Publications and source records attributed to F D'Angelo.

At least 19 recordsLinked to original sources
PubMed2007

Popliteal artery pseudoaneurysm after a revision of total knee arthroplasty: endovascular treatment with a stent graft.

Injury to the popliteal artery during total knee arthroplasty is a very rare but dangerous complication. Several mechanisms are capable of generating a direct trauma to the vessel, like posterior retractor and oscillating saw. We report a case of popliteal artery pseudoaneurysm in a 52-year-old woman that occurred during revision of total knee arthroplasty, requiring emergency repair by means of percutaneous endovascular covered stenting.

Aneurysm, False↗
PubMed2002

Axillary lymphectomy in breast cancer.

BACKGROUND: The aim of the study was to demonstrate the prognostic value of sentinel node biopsy compared to the sampling of clinically suspected nodes and lymphectomy of the 3 axillary levels. METHODS. From October 1996 to January 1999, 60 patients with breast cancer with a diameter of 4 cm or under using different procedures of axillary lymphadenectomy. Sentinel node biopsy was performed using Giuliano's technique, followed by lymph nodes larger than 5 cm (lymph node sampling) and lastly all axillary lymph nodes (axillary lymphectomy at 3 levels). RESULTS: Sentinel nodes were identified in all patients and a mean of 3 sentinel nodes (range 1-5) were removed during the procedure. Histological analysis showed metastatic sentinel nodes in 21 cases. Lymph node sampling was possible in 43 patients who presented enlarged nodes. The mean number of lymph nodes removed was 6 (range 3-10). Lymph node metastasis was found in 10 patients and of these 7 had a metastatic sentinel node, whereas 3 had presented negative results. Histological tests in all 60 cases of complete axillary lymphectomy showed positive results in 4 cases confirming metastasis present in sentinel nodes. CONCLUSIONS: The results show that the association of lymph node sampling can improve the efficacy of sentinel node dissection, highlighting the rare cases of false negatives. In our study, total axillary lymphectomy did not add any information to the N parameter and was resolutive in a small percentage of cases.

Adult↗
PubMed2001

Management of midclavicular fractures: comparison between nonoperative treatment and open intramedullary fixation in 80 patients.

BACKGROUND: The aim of this study was to compare the results achieved in two groups of 40 patients, treated for uncomplicated midclavicular fractures. METHODS: Group 1 (mean age, 37.2 years) underwent nonoperative treatment with a figure-of-8 bandage, whereas group 2 (mean age, 30.2 years) underwent open reduction and intramedullary fixation with a 2.5-mm threaded pin. The groups were similar with respect to fracture type. RESULTS: A high rate of complications occurred in group 2, including eight superficial infections, three refractures, two delayed unions with pin breakage, and two nonunions. Return to daily activities was undertaken after an average of 16.7 days from trauma in group 1, and after 40.7 days in group 2 (p = 0.00). Also, return to heavy and sport activities was more rapid for patients treated conservatively: 2.6 months versus 3.2 months (p = 0.014). At follow-up, which averaged 63.7 months, clinical evaluation according to the Constant rating scale did not show significant differences between the two groups. The absolute score averaged 84.8 in group 1 and 82.9 in group 2, whereas the mean relative scores were 94.9% and 95%, respectively. Thirty patients of each group were completely satisfied with the treatment received. The most common cause of dissatisfaction was represented by the unaesthetic appearance of the clavicle, because of subcutaneous bone prominence or dystrophic surgical scars. CONCLUSION: According to our experience, we conclude that nonoperative treatment appears more advantageous than open intramedullary fixation for the management of most midclavicular fractures.

Adolescent↗
PubMed2001

[Ambulatory surgical treatment for breast carcinoma].

BACKGROUND: The aim of the study is to demonstrate the feasibility and the oncologic effectiveness of quadrantectomy plus sentinel node biopsy performed under local anesthesia, and to demonstrate the economic and psychologic advantages. METHODS: From October 1996 to March 2000, 71 patients affected with clinical T1 N0 breast cancer, underwent quadrantectomy or tumor resection plus sentinel node biopsy and clinically suspicion axillary nodes biopsy, under local anesthesia at the Casa di Cura "Villa Mafalda" in Rome. RESULTS: Twenty tumors were T1a, 26 T1b e 25 T1c. A mean of 2 sentinel nodes (range 1-4) and a mean of 8 axillary nodes were removed during the procedure. In 2 cases sentinel nodes were not identified. Intraoperative histologic examination showed metastatic sentinel nodes in 11 cases. An axillary node dissection was performed in all cases (>12 nodes) and no other metastatic nodes were found. In all patients clinically suspected nodes were removed. In two cases no evidence of metastasis was found in sentinel nodes, while histologic examination revealed in a patient micrometastasis in one node, and in another patient two metastatic nodes. CONCLUSIONS: Fifty-three patients rated the overall surgical, anesthetic and recovery experience as "very satisfactory", 13 "satisfactory" and 5 "unsatisfactory". Patients typically expressed their pleasure at the possibility to return home and stressed the ease of recovery.

Adult↗
PubMed2001

[Endoscopic perforating vein surgery. Review of the literature and personal experience].

The endoscopic treatment of perforating veins incompetence of the legs has been recently introduced as an effective surgical therapy in serious cases of chronic venous insufficiency. According to CEAP classification, the primary indication is set on the class 5 or 6 patients, affected by active ulcers or relapsing ulcerative lesions. During the last two years, 53 operations of SEPS have been performed at the Vascular Surgery Unit of G. Salvini Hospital in Garbagnate Milanese. Here we present A perspective study of 24 cases with a 6 to 18 months follow-up is presented. In 8 patients (33%) an active ulcer was present, while in 16 cases history of relapsing ulcers was described. After the first month, all the lesions were healed and a subjective clinical improvement of the hypodermosclerosis was observed. At 12 months follow-up new ulcerations appeared only in four patients. On the basis the experiences of many authors and the results obtained in this study, following conclusions are made: the best results are achieved in case of sole perforating veins incompetence; the insufficiency of superficial venous circulation must be treated simultaneously or better previously, considering later the operation on the perforators veins; the sclerotherapy is introduced to cure the ectasic superficial veins in order to avoid a sponge effect with a precocious reappearance of the ulcers.

Adult↗
PubMed2001

A frameshift mutation in the human fibrinogen Aalpha-chain gene (Aalpha(499)Ala frameshift stop) leading to dysfibrinogen San Giovanni Rotondo.

We have investigated a 53-yr-old asymptomatic white man with decreased functional, but not immunologic, fibrinogen plasma levels together with prolonged thrombin and reptilase times, detected through routine coagulation studies prior to a surgical procedure. A new heterozygous single nucleotide deletion (C) at position Ala499 within the Aalpha-chain gene was identified, which predicted changes of the corresponding amino acids encoded by the subsequent portion of the exon V and the appearance of a premature stop codon at position 518 (Aalpha[499]Ala frameshift stop). The new dysfunctional fibrinogen, San Giovanni Rotondo variant, was confirmed in vivo by SDS-PAGE analysis of HPLC-purified fibrinogen chains. Mass spectrum examination of the abnormal HPLC-purified peak gave an estimated mass (56,088 Da) similar to that predicted by DNA analysis of the mutated Aalpha-chain gene (56,088 Da) and, after tryptic digestion, the truncated Aalpha-chain was shown only in the propositus, who also carried normal Aalpha-chain. In addition, mass spectrum analysis of the tryptic digest of the abnormal chain confirmed the presence of a new and unpaired cysteine at the last position that was predicted to form a disulfide bridge with human serum albumin. Immuno-blot analysis confirmed that fibrinogen San Giovanni Rotondo variant, but not normal fibrinogen. contained substantial amounts of albumin. Present findings confirm that truncated Aalpha-chain lacking part of the terminal domain may be incorporated into mature fibrinogen molecules and normally secreted in the bloodstream.

Afibrinogenemia↗
PubMed2000

Chaos healing by separatrix disappearance and quasisingle helicity states of the reversed field pinch.

The resilience to chaotic perturbations of one-parameter one-degree-of-freedom Hamiltonian dynamics is shown to increase when its corresponding separatrix vanishes due to a saddle-node bifurcation. This is first highlighted for the magnetic chaos related to quasisingle helicity (QSH) states of the reversed field pinch. It provides a rationale for the confinement improvement of helical structures experimentally found for QSH plasmas; such a feature would not be expected from the classical resonance overlap picture as the separatrix disappearance occurs when the amplitude of the dominant mode increases.

Journal Article↗
PubMed1999

[Use of vascular endostapler in surgery of the lower rectum].

A practical and effective method for rapid and bloodless preparation of the rectum using endovascular stapler devices during low anterior resection, or abdominal-perineal excision, is described. This method is presented as an effective means for easily dividing the anterior and lateral attachment of the rectum. The application of this technique is the absence of intraoperative bleeding related to injury of middle hemorrhoidal vessels, with minimal risk of autonomic pelvic nerve damage. An additional factor relevant in the choice of this technique, is the easier possibility to perform rectal dissection of an oncologically adequate tumor clearance from the margin of rectal tumor and with complete radical transection of the lateral ligaments fastly proceeding with the downward mobilization of the rectum close to the pelvic side walls, between the parietal and visceral layer of the pelvic fascia.

Adenocarcinoma↗
PubMed1996

[Aneurysm of the popliteal artery. A case contribution of a 15-year surgical experience].

This retrospective study involves 45 patients operated in the years 1980-1994 for popliteal artery aneurysms with a posterior approach. The number of aneurysms is 60 because 15 were bilateral; 18 patients presented a polianeurysmatic involvement of the arterial tree. In 14 cases the intervention were performed on asymptomatic patients, in 46 cases the patients were symptomatic for ischemic disease. The reconstructive interventions were performed on 58 cases and only in 2 cases the medial approach to popliteal vessel were preferred on the basis of the great dimension of the aneurysms which involved also the superficial femoral artery. PTFE grafts were adopted in 33 cases, saphenous vein in 19 cases and Dacron grafts in 5 cases. We had no perioperative mortality and 4 patients died for causes not correlated to the intervention. We had perioperative complication in the group of asymptomatic patients. In the group of symptomatic patients 5 underwent a major amputation. The global patency of these grafts is 86% after 10 years. The posterior approach to the popliteal vessels has the advantage of a better view of the aneurysmatic mass and the anatomic structures and it permits a direct end graft. This graft is usually shorter than in the case of the medial approach and cannot be compressed by the aneurysmatic mass.

Aged↗
PubMed1994

[Changes in the alveolar bone after periodontal therapy. A follow-up by computerized radiographic analysis].

In this study the authors evaluated radiographic variations of alveolar bone treated with periodontal therapy, through computerized analysis. Five adult patients with severe periodontitis were included in this study. In everyone of these patients, three sites were selected and treated in the following ways: 1) root planing (LCC), 2) open flap debridement (LCA) and 3) guided tissue regeneration with polytetrafluoroethylene membrane (GTR-PTFE). Every site was subjected to radiographic examination before treatment and six, eight, twelve and twenty-four weeks later. Radiographic images were evaluated through digital processing in order to show and compare one to another changes of alveolar bone of sites treated with different therapeutic procedures. Analysis of data indicated that sites treated by GTR-PTFE developed better than sites treated with other therapeutic procedures and evolution of sites treated with surgery was usually characterized by a beginning phase of alveolar bone loss and by a phase of variable bone regeneration later. Early variations of alveolar bone have been pointed out by mean of this computerized analysis.

Adult↗
PubMed1994

[The effects of ultramicronized synthetic hydroxyapatite on the etched enamel. An in-vitro study with computerized analysis].

The authors studied in vitro effects produced by etching (37% H3PO4) 80 microns thick teeth sections and the following application of H.A.u.m (Apagen). The changes of the superficial and lower layers were investigated by gray level alterations of section images. The changes were investigated by using a computerized image analysis system, by pseudocolors, standard deviation of gray levels and by calculating the surface rate affected by significative alteration. Etching application increased extension of high gray level zones. Pseudocolors showed 35 microns depth alterations. the evaluation of standard deviation means that major changes affected superficial layers; the evaluation of the extension of low gray levels zones showed a restoration of the pretreatment optical pattern. The results of this study demonstrate that H.A.u.m. (Apagen) applications are able to remineralize both superficial and lower layers of etched enamel.

Acid Etching, Dental↗
PubMed1993

Is age an important risk factor for the outcome of elective abdominal aneurysm surgery?

This retrospective study involves 590 patients who underwent elective abdominal aortic surgery in the years 1966-1990. These patients are subdivided into three groups by time of intervention: 1st = 1966-1978; 2nd = 1979-1988; 3rd = 1988-1990, and each group is subdivided into two subgroups according to whether age is over or under 70. A progressive decrease in mortality is statistically significant through these years. No difference in the age-subgroups were observed except for a greater rate of minor postoperative complications. Elective surgical repair of aneurysmatic disease of the abdominal aorta is a safe procedure also in patients over 70 years in the presence of correct hemodynamic intraoperative monitoring and of a skilled surgical equipe.

Age Factors↗
PubMed1993

Changing trends in the outcome of urgent aneurysms surgery. A retrospective study on 170 patients treated in the years 1966-1990.

During the last 25 years 170 patients with ruptured aortic aneurysms were treated in our centre for vascular surgery with an overall mortality of 54%. We have subdivided these patients into three groups according to temporal factors: the 1st group includes 16 patients treated in the years 1966-1978; the 2nd group includes 93 patients treated from 1979 to 1987; the 3rd group includes patients from 1988 to 1990. In these years no selection of patients was made and everybody still alive was operated on. Starting from the second period, haemodynamical monitoring of the patients was performed with the adoption of the Swan-Ganz catheter in almost all cases. Mortality in the first period was 69%, in the second period 60% and in the third period 40%. There was no difference in the haemodynamical state in the three groups. The difference lies in the number of surgical interventions per year: 1.33 intervention per year in the first period; 11.625 interventions per year in the second period and 20 in the third. We conclude that an improvement in the survival rate of patients undergoing urgent aortic aneurysm repair is due to precise haemodynamical intraoperative monitoring and a well trained surgical team.

Age Factors↗
PubMed1991

Hepatic resections for colorectal metastases: the Italian multicenter experience.

In 1989 there were 151,000 new cases of colorectal carcinoma in the United States. Approximately 50% of these patients will be at risk of developing liver metastases together with other sites of recurrence. However, the liver will be the main site of relapse in only 14,000 patients with colorectal cancer. Approximately 25% of patients with colorectal carcinoma have technically resectable hepatic metastases at the time of operation for primary lesion, and an additional 8-25% will develop metachronous hepatic metastases after primary resection. Recent reported experiences with surgical treatment of metastatic colorectal cancer in the liver seem to indicate that hepatic resection has become more acceptable, safe and effective therapy, and offers today when technically possible, the best prospect of survival in a conspicuous number of patients. For these reasons, although a prospective randomized trial has not been done comparing resection with nonresection, resection seems to give the best hope for cure and actually is the treatment of choice for selected patients. In fact in these patients is reported a significant prolongation of survival compared with those patients with unresectable liver metastases treated only with adjuvant therapy in the form of chemotherapy or radiation therapy. Median survival of resected patients with hepatic metastases has been reported to range from 6-12 months, and for patients with single metastases is reported to range from 4.5-6.2 months to 11 and 21 months. The benefits of surgical therapy have been emphasized by different experience, with a 5-year overall survival rate ranging from 20-40%. In a recent multicenter survey a 33% 5-year survival rate was demonstrated in 859 patients resected for hepatic metastases.

Adenocarcinoma↗