PubMed Health⌕ Search

Biomedical subjects

G Ussia

Publications and source records attributed to G Ussia.

At least 19 recordsLinked to original sources
PubMed2004

[Tension-free laparoscopic versus open inguinal hernia repair].

AIM: During the last decade laparoscopic techniques have been applied to the treatment of inguinal hernia to combine tension-free technique, esthetic, and functional benefits of mini-invasive surgery. Anyway controversy persists regarding the most effective inguinal hernia repair. The aim of this study is to compare the open technique and the laparoscopic approach concerning: complications, recurrences, recovery time and return to usual activity. METHODS: A randomized prospective analysis of 121 consecutive inguinal hernia repairs was performed over a 12-month period. Male well-informed patients with primary monolateral inguinal hernia (ASA I-II) were divided into 2 groups and consecutively treated; group A was treated with laparoscopic transabdominal preperitoneal approach (TAPP) (median age 47+/-7 years, 57 patients), group B with open mesh herniorrhaphy (45+/-6 years, 64 patients). RESULTS: Complication rate was 5.26% for group A (none needed conversion) and 4.68% for group B. All complications were considered minor. No recurrences were observed over a 12-month follow-up in both groups. Post-operative hospital stay and return to activity show statistically significant differences. Median post-hospital stay was 1.7 days for group A while it was longer (2.9 days) for group B. Significant difference was observed in the duration of convalescence too (group A 9.3+/-7.2 days; group B 12.1+/-7. 1 days). CONCLUSION: On the basis of our experience, even if a longer follow-up is needed, the validity of laparoscopic approach to inguinal hernia is confirmed. General anesthesia and higher costs are reasonable compromises for a shorter period of discomfort in patients with a low ASA index and busy job/sport activity.

Adult↗
PubMed1998

Combined laparoendoscopic colon resection and anastomosis using the "no touch technique" and fibrin glue. An experimental study.

BACKGROUND: Laparoscopic colon anastomosis are technically demanding. A new technique for colon resection and anastomosis using a combined laparoendoscopic approach is presented. METHODS: In 10 pigs, pneumoperitoneum was induced and 5 trocars were placed. A sigmoid segment was isolated; a vein stripper was inserted from the anus, and the head was secured with a tie; the segment was intussuscepted pulling the stripper out; 4 seromuscular sutures were placed at the anastomotic site and fibrin glue was spread all around; an electrical wire loop, introduced via a colonoscope, was used to resect the intussuscepted segment that was removed from the anus. RESULTS: All animals but one survived until sacrifice at 30, 60, 90, and 120 days. Macroscopically, the anastomosis appeared well healed; microscopically, after 90 days, there was a complete restitutio ad integrum of the intestinal wall. CONCLUSIONS: This technique is feasible and quick; it could be used clinically in small tumors not removable endoscopically.

Anal Canal↗
PubMed1998

Autologous vein lined and vein covered stents in swine arteries. An experimental study to assess and compare patency and intimal hyperplastic response.

BACKGROUND: Despite the success of arterial angioplasty as well as arterial stent placement, restenosis remains a significant problem in prolonging blood vessel patency. This animal model was used to test the theory that a stent lined (VLS) or covered (VCS) with autologous vein would be more biologically compatible with the arterial intima. If successful, this technique would prevent angioplasty failure due to intimal hyperplasia (IH) by supplying a healthy endothelial surface and help to eliminate elastic recoil mechanism (ERM) by the use of a stent rendered less thrombogenic in both stenosed and restenosed arteries. There might in addition, be other applications for these modified stents. METHODS: Nine 50 kg -young pigs had Gianturco-Roubin VLS and VCS mounted on a balloon angioplasty catheter implanted via a transverse arteriotomy. VLS were implanted in 3 left iliac and 6 left carotid arteries and VCS were placed in the matching contralateral arteries. The change from iliac to carotid arteries was due to the initial perception that the iliac artery was the right size for this device. It proved to be too large and the carotid artery, which was initially felt to be too small proved to be the right size. Operative angiography was performed to ensure proper placement. Duplex imaging of the carotid artery placements were performed at 10-14 days. All animals were sacrificed at 30-33 days and specimens examined grossly and microscopically. Three 16.5% of the devices were found to be patent, two VILS and one VCS. The remaining 14 (78%) were occluded by distortion or thrombus or both. RESULTS: Five devices migrated distally, 2 of which remained patent albeit of smaller diameter. One device migrated to the brain, was not recovered and was presumed occluded. All arteries and veins, with two exceptions, demonstrated varying degrees of IH. We believe failure was due to the inability of the stents to resist ERM in these healthy pig arteries. The IH observed, we believe, is due to the forced dilatation required to seat the devices. CONCLUSIONS: Based on the observations of the patent devices we suggest that arteries can be relined and supported with modifications of this technique, using a more ERM resistant stent that may be placed without forceful dilatation. This will require further study.

Animals↗
PubMed1995

Role of pharmacologic tests in the treatment of primary pulmonary hypertension.

Primary pulmonary hypertension (PPH) is a rare disease of unknown etiology characterized by a constant progression toward right ventricular failure and death. Vasoconstriction is 1 of the pathophysiologic factors responsible for the increase of pulmonary vascular resistance (PVR) and pulmonary artery pressure (PAP) in patients with PPH. Thus vasodilator treatment is considered 1 of the logical approaches to medical therapy of such a condition. Acute drug challenge with a short-acting, titratable vasodilator during heart catheterization is recommended to select patients who are most likely to respond to long-term treatment. Accurate methodologic guidelines need to be followed to minimize the spontaneous variability of PAP and pulmonary arteriolar resistance. Pathophysiologic interpretation of pharmacologic trials requires analysis of the 2 components of the right ventricular hydraulic load, i.e., resistance and compliance of the pulmonary vascular bed. Reduction of the calculated PVR may be considered as a demonstration of pulmonary vasodilation only if PVR is assessed using the critical opening pressure or if it is associated with a simultaneous reduction of PAP. Only those patients in whom a reduction of PVR of > or = 20% is associated with a decrease in PAP of > or = 20% should be considered as "responders" to the acute tests. In clinical studies only 20-30% of the patients are short-term responders. The most intensively studied short-acting drug for short-term challenge is prostacyclin, but other agents such as acetylcholine, adenosine, and nitric oxide have been utilized. Prostacyclin has been shown to predict pulmonary vasodilator response to the administration of long-acting vasodilators, such as calcium channel antagonists.(ABSTRACT TRUNCATED AT 250 WORDS)

Hemodynamics↗
PubMed1992

Bile acid active and passive ileal transport in the rabbit: effect of luminal stirring.

The intestinal absorption of bile acids (BA) with different chemical structure has been evaluated in the rabbit, after intestinal infusion of different concentrations (0.25-30 mM) of BA, by mesenteric blood sampling. Cholic (CA), chenodeoxycholic (CDCA), ursodeoxycholic (UDCA) acid, free and taurine (T-) conjugated, together with glycocholic (GCA) acid and deoxycholic acid (DCA) were studied. The apparent uptake parameters were calculated. All conjugated BA showed active transport (T max, nmol min-1 cm-1 int.), with Tmax values in the following order: TCA > TUDCA > TCDCA; unconjugated BA showed passive uptake, with values in the following order: DCA > CDCA > UDCA > CA. GCA and CA showed both passive uptake and active transport. For all BA studied the % uptake in the ileal segment considered was less than 10%, BA uptake being thus limited by transport and/or diffusion kinetics, rather than by flow velocity. The liquid resistance to BA radial diffusion inside the lumen was evaluated, and the infusate-to-blood uptake parameters corrected for it, in order to get the uptake parameters from the epithelium-to-liquid interface to mesenteric blood: the apparent Km decreased, passive uptake coefficient increased, while Tmax was unchanged. The passive component of the uptake, corrected for the luminal resistance, correlated with the BA hydrophobicity (r = 0.963; P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Reduced neutrophil superoxide generation and plasma lipoperoxide levels in pigs fed with cod liver oil.

Circulating neutrophils, isolated from pigs fed for 8 weeks with a diet supplemented with CLO, had an accentuated n-3 fatty acid incorporation into the plasma membrane, as evidenced by an approximately four-fold greater n-3/n-6 ratio as compared with the control diet group. Moreover, the neutrophils of the CLO fed pigs produced less superoxide when stimulated with PMA or f-MLP, as well as showing a more prolonged latency period before O2(-)-generation. In the plasma of pigs fed with CLO there were higher levels of thiobarbituric reactive material and lipofuscin, while the content of GSSG was similar in both dietary groups. The results of this study indicate that dietary supplementation with CLO reduces the activation of circulating neutrophils and favours the presence in the plasma of lipoperoxides.

Animals↗
PubMed1990

Evaluation of the ileal absorption capacity for bile acids in the rabbit.

The intestinal absorption of bile acids has so far been studied from the measurement of the biliary secretion after their intestinal infusion. In the present investigation, the ileal absorption capacity for two different bile acids has been evaluated by means of an intestinal perfusion technique and the simultaneous blood drainage from the mesenteric vein corresponding to the isolated loop. Taurocholic acid and unconjugated cholic acid were infused at different concentrations (0.5-10.0 mM), at a flow rate of 4 ml/min/cm intest. Taurocholic acid absorption increased to a maximum with dose, then reaching a plateau, suggesting that a saturable process had taken place. Cholic acid uptake showed a saturable, possibly active, process, together with a nonsaturable one. These results are consistent with the physicochemical properties of the two bile acids. The technique seems so far suitable for the study of the intestinal absorption of substances undergoing the enterohepatic circulation, since it provides a direct measure of the absorbed fraction, without any distortion arising from the hepatic uptake and biliary secretion.

Animals↗
PubMed1989

Long-term patency of regenerated neoaortic wall following the implant of a fully biodegradable polyurethane prosthesis: experimental lipid diet model in pigs.

The degradation of a polyurethane vascular prosthesis, the time course and characteristics of tissue ingrowth and prosthesis replacement, and the incidence of thrombosis have been investigated in 50 young pigs. A 6-7 cm long cone-shaped prosthesis was implanted in the infrarenal aorta of 50 young growing pigs which were sacrificed at intervals from 60 to 365 days. Ten animals were controls, 25 were given aspirin 10 mg/kg of body weight/day, and 15 were fed with cod liver oil. Aortography, done at 30, 60, and 90 days, showed 100% of implants were thrombosed in the surviving controls, 55% of the aspirin group had patent grafts, and 100% of animals in the lipid diet group had patent grafts. At final graft retrieval, the aspirin group showed only three patencies, while in the lipid diet group seven out of nine animals were patent. The laboratory and morphological studies indicated that all patent prostheses were lined with tissue that resembled the intima of native aorta with a layer of smooth muscle cells which appeared complete at 180 days. From these data we conclude that the biodegradable polyurethane vascular prosthesis is reliable for experimental implants in a pig model. The lipid-rich diet of polyunsaturated fatty acids potentiates long-term patency, perhaps by preventing platelet aggregation and thrombosis, and allowing the growth of a neoendothelium and neomedia within the lumen of the prosthesis, which slowly degrade towards fatty tissue and form neoadventitia.

Animals↗
PubMed1989

Prevention of platelet aggregation by dietary polyunsaturated fatty acids in the biodegradable polyurethane vascular prosthesis: an experimental model in pigs.

A 6-7 cm long degradable polyurethane vascular prosthesis was implanted in the infrarenal aorta of 25 young growing pigs, sacrificed from day 30 to 365 to study the processes of degradation and tissue growth, the characteristics of prosthetic substitutes and the incidence of thrombosis. Ten animals were used as controls and 15 were fed with cod liver oil (25 ml twice daily). Aortography performed at day 30, 60 and 90 showed 100% thrombosed implants in the controls, while in the lipid diet fed animals there was 100% patency. At graft retrieval, there were 7 patent grafts out of 9 in the cod liver oil fed animals. Laboratory tests indicated that the lipid diet rich in n-3 polyunsaturated fatty acids induces significant modifications of lipid metabolism preventing platelet aggregation. These data correlate well with findings of the morphological studies showing that all patent prostheses are lined with tissues similar to the endothelium of the native aorta with a mid layer made of circular and longitudinal smooth muscle cells well differentiated at day 180. These data show that the essential polyunsaturated fatty acid rich diet is able to prevent thrombosis of the biodegradable polyurethane vascular prosthesis. The combination of a synthetic material and the lipid diet experimental model, makes it possible to assess the long-term tissue-synthetic material interaction and the process of tissue growth.

Animals↗
PubMed1985

Histopathological aspects of tissue reactivity to suture materials in microsurgical arterial, anastomosis.

In order to assess tissue reactivity to synthetic suture material in microsurgery, a histological study was carried out in 20 rabbits divided into two groups: "A" and "B". The aorta of the animals was sectioned and subsequently anastomosed using polyglycolic acid in the first group and monofilament nylon in the second group. The animals were sacrificed at 10, 20, 40, 60 and 90 days after surgery, and the specimens were studied both macroscopically and microscopically. Tissue reactivity during the initial 40 days had similar histological characteristics in both groups evidentiating a perisuture granuloma with macrophages and giant cells. The second period, 40 to 90 days after surgery, was characterized by a tissue reactivity specific for each type of suture. In group "A", the inflammatory process diminished in parallel to the absorbtion of polyglycolic acid with "restitutio ad integrum" of the vessel wall. In group "B", the inflammatory process persisted due to the presence of non absorbable monofilament nylon, thus causing a fibrosclerotic transformation of the vessel wall. The results of this study suggest that the most suitable suture material for anastomosing living tissues are absorbable sutures.

Animals↗
PubMed1984

Comparison of the effects of polyglycolic acid and monofilament nylon sutures in the common bile duct of pigs.

The tissue reaction and involvement of cells in the common bile duct of young pigs after surgery with two suture materials, polyglycolic acid and monofilament nylon, have been described. By comparing the different tissue reactions to the suture materials the authors observe that the use of non-absorbable polymer sutures and their long lasting presence in living tissues, may interfere with the healing process, since the sutures tend to migrate within the common duct wall and be expelled into the lumen owing perhaps to the delayed immuno-allergic reaction which develops in the common duct wall. In contrast polyglycolic acid seems to be biologically well tolerated and well integrated as a suture material, which is reabsorbed with the help of cell enzymes producing a complete restitutio ad integrum of the wall.

Animals↗