Biomedical subjects
Publications and source records attributed to M Osti.
Combined fracture of the scaphoid and capitate bones with concurrent scapholunate dissociation, but without severe dislocation, is a rare lesion which results in significant carpal instability and requires operative treatment. We report a case of this unusual injury and its functional result after 20 months.
A 38-year-old patient had a right radical (Patey) mastectomy for an infiltrating ductal carcinoma followed by chemotherapy and, one year later, a TRAM flap breast reconstruction. She was given clear and exhaustive information about the possible consequences of pregnancy, but despite this she became pregnant four months after the reconstruction. The pregnancy was taken to term despite the appearance at four months of a slow-growing abdominal hernia. In the light of our experience and that of others, we recommend an interval of at least 12 months between breast reconstruction with a TRAM flap and pregnancy.
This paper describes the use of oxidized dextran as a cross-linker for the preparation of gelatin microspheres. Microspheres were obtained by a thermal gelation method and their dissolution kinetic was examined. In order to find evidence of sugar mediated cross-linking, swelling tests and gelatin microspheres dissolution experiments were performed. The obtained results indicated that oxidized dextran can form a cross-linked gelatin network which can reduce the dissolution of gelatin. More interestingly, gelatin microspheres treated by both native and oxidized dextran slow down, even if to a different extent, the release of the antitumor drug TAPP-Br used as a model compound. Taken together, our results suggest that oxidized dextran could be an interesting means to cross-link gelatin microspheres allowing the use of this delivery formulation for controlled release of drugs.
Malignant transformation of spiradenoma is a very rare event and its biologic features have not been fully described. Clinically, these tumours are characterized by the rapid enlargement of a long-standing cutaneous nodule. Microscopic examination discloses the presence of the two components, benign and malignant, whose morphological distinction is not always easy. We report the occurrence of a spiradenocarcinoma within a pre-existing spiradenoma of the cheek in a 48 year old man and review the previously reported cases especially on the basis of their morphological and immunohistochemical characteristics.
Authors report a Launoise-Bensaude-Madelung disease case, in a 64 year old man, admitted to a Plastic Surgical Department for obesity, dysphonia, dysphagia, dyspnea. Early symptoms appeared 20 years before Hospital admission. Lipomatous tissue occupied nape, mandible, neck and shoulders. Surgical exeresis of lipomatous tissue under general anesthesia needed for the patient. Neck movements and mouth opening were short (Mallampati Score = 4); a neck computed tomography showed a tracheal compression and right displacement. Tracheal intubation was considered difficult or impossible. Nose-tracheal intubation was performed using a pediatric fiberoptic instrument as guide for a small gauge tracheal tube. Tracheal stenosis required many attempts for correct nose-tracheal intubation. Fiberoptic instrument as guide for tracheal tube can be useful for patients with Launoise-Bensaude-Madelung disease, when tracheal intubation is considered difficult or impossible. Knowledge of fiberoptic tracheal intubation techniques is mandatory for anesthesiologists, allowing tracheal intubation in patients with anatomical variations of mouth or upper respiratory airways.
Recently we have evaluated the relationship between benzo[a]-pyrene(BaP)-DNA adducts, determined by 32P-postlabelling, and clone frequencies in the somatic mutation and recombination test (SMART) in Drosophila melanogaster. Following that study we proceeded to characterise further the mechanism of induction of genetic damage in vivo by BaP in Drosophila by cytogenetic analysis of larval brain neuroblasts. Third stage larvae were treated with 4 and 10 mM BaP for 24, 48 or 72 h. In all cases, the larvae were killed 72 h after the beginning of treatment, entailing 48, 24 or 0 h post-treatment recovery in BaP-free medium, respectively. At the end of the treatment the following data were collected: (i) the types and levels of chromosome aberrations in neuroblast metaphase and anaphase nuclei; (ii) the distribution and level of BaP-DNA adducts, revealed by indirect immunofluorescence in neuroblast nuclei using an anti-(BaP-DNA) antibody. The results indicate that BaP induces chromosome breaks, deletions and exchanges in this system. In particular, chromosome exchanges decrease as the post-treatment recovery time increases, and the dynamics of breaks and deletions appear to be inversely related to those of the exchanges. This suggests that exchanges may require few preconditions to occur and are thus expressed soon after treatment. Chromosome breaks and deletions could require multiple single events before the actual damage is expressed (even some cell divisions away from the end of treatment). The immunofluorescence analysis suggests that BaP-DNA adducts are more abundant in the heterochromatin of the neuroblast nuclei.(ABSTRACT TRUNCATED AT 250 WORDS)
The evaluation of the relationship between the dose to DNA of a mutagen/carcinogen and in vivo somatic cell mutagenesis may provide information on the mechanisms leading to induced mutational events. This can be achieved, for example, by coupling test systems that permit the detection of somatic mutation and recombination on the basis of phenotypic changes in cuticular structures of Drosophila melanogaster, with methods for the quantitation of carcinogen-DNA adducts such as the 32P-postlabeling technique. In this article, we evaluate the quantitative relationship between BaP-DNA adduct formation, determined by 32P-postlabeling, and the induction of mutant cells in the wing marker version of the somatic mutation and recombination test (SMART) in Drosophila melanogaster. The total single clones in the trans-heterozygous mwh/flr3 flies show a linear relationship with the BaP-DNA adduct levels, suggesting a single hit mechanism for the genetic damage giving rise to this type of clones. In contrast, the twin clones (which are of recombinational origin) display a linear-quadratic relationship with the adduct levels, suggesting that multiple hits may be involved in generating these clones. The total single clones in the mwh/TM3, Ser flies (in which mitotic recombination is suppressed) show a logarithmic relationship with the adduct levels. The discussion of these data in terms of the pathways that may be involved in the repair of the BaP-DNA adducts leads to the suggestion that in Drosophila melanogaster the repair of Bap metabolite-DNA adducts in somatic cells may proceed, in large part, via post-replicative recombinational repair.
In order to characterise the response of the wing spot test in Drosophila melanogaster to the effects of compounds with known aneugenic properties, experiments were performed with chloral hydrate (CH). Following chronic exposure of 72-h-old larvae to rising concentrations of CH, significant increases in the frequency of small (1-2 cells) single spots were observed. Comparison of results obtained in parallel from the wings of marker-trans-heterozygous individuals and individuals heterozygous for one of two different balancer chromosomes suggests that practically all the single clones originated from recombinational events. Twin clone frequencies were, however, only weakly affected. These results are discussed with reference to the literature regarding the effects of CH in different experimental systems and to the characteristics of Drosophila as a tester organism.
The authors analyse the results of treatment with radiotherapy with therapeutic doses and traditional fractionation scheme 60 patients affected by bladder cancer, from 1980 through 1991, at the Institute of Radiology of the University "La Sapienza" in Rome. We evaluated the association of radiotherapy (RT) with trans-urethral resection and biopsy (TURB) and the association of RT with cystectomy (total or partial), both in T1-T2 and T3-T4 bladder stages. The mean follow-up was 85 months (from 24 months to 11 years). The survival at 5 years after completing the treatment was 33.3%; the survival of stages T1-T2 was of 40% at 5 years while that of stages T3-T4 was of 28.5%. Our study shows that the association of radiotherapy and TURB for T1 or T2 bladder cancer is an alternative to mutilating surgery like total or partial cystectomy; in this group, indeed, we showed a survival of 54.5% at 5 years as compared to the 28.5% of the group treated with cystectomy + RT. For T3 and T4 bladder cancer we had better results with surgery (total or partial cystectomy) and RT: in these patients the survival at 5 years was of 31%, while the group treated with TURB + RT showed a survival of 19%.
The genotoxicity of a chelating agent, the trisodium salt of nitrilotriacetic acid (NTA), was assessed in a somatic mutation and recombination test (SMART) in Drosophila melanogaster employing the wing hair markers mwh and flr3. The experiments were performed in parallel in two different laboratories (Padua, Italy and Schwerzenbach, Switzerland). The effectively absorbed doses of NTA, which was administered by feeding to larvae, were determined by a sensitive method employing [3H]leucine which allowed individual consumption levels to be measured. The particular pattern of clone induction produced by this compound suggests that NTA is active in inducing mitotic recombination and possibly aneuploidy in somatic cells of Drosophila. This is discussed in relation to the data present in the literature regarding the genotoxicity of NTA in a variety of experimental systems.
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In post-traumatic amputations, in particular in leg amputations, the presence of an unstable scar or of ulcerous areas that are difficult to heal in the site of the amputation stump constitutes a repair problem that is not easily solved. In this specific field of reconstruction skin expansion has earned significant agreement, and is even considered to be a safe and reliable method for the surgical rehabilitation of the amputation stump, allowing us to obtain high-quality tegumentary covering, with no excessive thickness, that adapts well to the prosthesis and to the underlying skeleton, and that is characterized by good sensitivity of protection. Tegumentary amplification may, in some cases, also become myocutaneous, allowing us to obtain more tissue thickness for protection in patients submitted to chronic loading that lasts longer and in those with thin teguments, in which traditional expansion could determine excessive narrowing of the tegumentary covering, following atrophy caused by compression of the subcutaneous adipose tissue.
BACKGROUND: Reconstructive breast surgery using the myocutaneous flap of the latissimus dorsi muscle with simultaneous insertion of a prosthesis represents a very useful procedure from a clinical standpoint. METHODS: Twenty-one breast reconstructions were performed using this type of surgery at the Plastic Surgery Clinic of the University of Udine between December 1993 and December 1995. RESULTS: Good aesthetic results can be obtained due to the relatively moderate functional and scarring complications, as well as to the vitality of the transposed tissue. The percentage of capsular contractures observed frequently in the past was lowered through the use of technologically-advanced prosthetic materials with a texturized surface. CONCLUSIONS: In addition, since the reconstructed breast can be expanded postoperatively through definitive Becker expanders, aesthetically satisfactory results can be achieved even with contralateral ptosic and/or large breasts.
The ideal goal of every post-mastectomy breast reconstruction is to achieve a breast that is as "identical" as possible to the contralateral one in shape, size, consistency, mobility and degree of naturalness. At the same time, however, it is essential to rely on the simplest and safest reconstruction technique as far as the patient is concerned. Mastectomy and restoration of the lost morphology should be performed in a single operation whenever the opportunity arises and there are two reasons for this. First of all, by working this way reconstruction can be performed on an area that is completely free of any scar tissue. Secondly, there are psychological considerations involved, since this makes it possible to avoid the trauma of letting the patient seeing herself, even for just an instant, without her breast. The numerous different techniques used for the morphological reconstruction of breast volume can be classified into two basic groups: reconstruction with insertion of a prosthesis and reconstruction without a prosthesis. Both of these techniques make it possible to personalize surgical choices based on the patient's unique characteristics, in order to achieve a complete symmetry in relation to the contralateral breast.