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Biomedical subjects

R B Bragaglia

Publications and source records attributed to R B Bragaglia.

17 recordsLinked to original sources
PubMed1990

Urogenital dysfunction after abdominoperineal resection for carcinoma of the rectum.

The long-term urogenital dysfunctions in 46 of 104 surviving patients submitted to abdominoperineal resection for rectal carcinoma between 1972 and 1986 were collected and assessed. Urinary retention was present in 41 percent of the men and 35 percent of women, while incontinence was present in 10 percent of men and 29 percent of women. Impotence was reported by 59 percent of the males, all sexually active before surgery. Dyspareunia was present in 50 percent of the women in the study. The possibility of treating prostatic hypertrophy concurrently with abdominoperineal resection in selected cases to avoid urinary retention is discussed. The limited number of responders to the survey may interfere with the global statistical significance.

Abdomen↗
PubMed1989

Survival and complications after radical surgery for carcinoma of the rectum.

The results of 164 abdominoperineal resections and 87 anterior resections carried out between 1972 and 1985 for cancer of the rectum were reviewed, assessed, and compared. The problems with anterior resection included a 1.1% hospital mortality and a 5.4% anastomotic failure rate in the 73 manual sutures and 28.5% in the 14 mechanical sutures; recurrence rate was 15.4% and the global 5-year-survival was 62%. There was no mortality in the Miles series; the recurrence rate was 4.8% and the 5-year-survival rate was 53.5%. Urogenital complications after Miles were found in 86.9%: urinary alone 10.8%, sexual alone 19.5%, both 56.5%.

Carcinoma↗
PubMed1979

[Diagnosis of chronic reflux esophagitis. Role of endoscopic and histological examination].

Fibroendoscopic and histobioptic study of the distal oesophageal mucosa has been carried out in a series of patients suffering from gastro-oesophageal regurgitation. The regurgitation condition was verified and its extent established by means of anamnestic, spot-fluorographic and manometric-pHmetric investigations. On the basis of the analysis of relations between the extent of the oesophagitis assessed on the basis of endoscopy and that arising out of microscopic examination of the biopsy, it is concluded that there is no complete correspondence between the two techniques insofar as endoscopy can give false positive or false negative results. On the basis of these results and of those of functional investigations, histology is considered desirable even when the oesophageal mucosa is normal, if there are clinical and/or laboratory signs of gastro-oesophageal regurgitation.

Adult↗
PubMed1979

Tracheobronchial ruptures due to cuffed Carlens tubes.

At our institution in the past 22 years, more than 3,000 patients have undergone chest procedures, and 2,700 of them were intubated with a cuffed Carlens endotracheal tube. In this paper we report on 5 patients with tracheobronchial ruptures caused by intubation with these tubes. We believe this hazard should be brought to the attention of physicians.

Adult↗
PubMed1979

Technique for the management of anterior flail chest.

A technique for the management of anterior flail chest consisting of osteosynthesis and the positioning of two long Kirschner wires behind the sternum in the form of a St Andrew's cross is described. The procedure is easy to perform, the patient is ambulant early, and the results are good.

Fracture Fixation, Internal↗
PubMed1977

An in vitro study on the interaction between dimethylnitrosamine and nucleic acids via a microsomal system.

Radioactive alkylated bases, ribose or phosphate, were never found either in acid and alkaline hydrolysates of polyribonucleotides or in alkaline hydrolysates of DNA after incubation with 14C-dimethylnitrosamine (DMNA) in a microsomal system. Two radioactive compounds, which were co-chromatographed with methylamine and N-methylhydrazine, respectively, on column, paper, and thin-layer, were always detected. They differed from the compound derived from 7-methylguanosine after the alkali-mediated fission of the imidazole ring in its molecule. The in vitro system employed well represents the in vivo situation (7-methylguanine which is liberated from DNA after acid hydrolysis); however, it has given results which do not agree with the generally-accepted mechanism of DMNA alkylation at the N-7 position of guanine.

Animals↗
PubMedDate not supplied

The "Kergin pneumonectomy".

Out of a series of 211 stage III (A and B) lung cancers radically resected with routine lymphadenectomy from 1971 to 1987, a total of 11 were squamous cell carcinomas invading the right main bronchus and lateral portion of the trachea. These patients were managed using a particular technique that we have always arbitrarily called, "Kergin pneumonectomy," after the Toronto surgeon who described it in 1952. These patients, today, are staged III B. There was no operative mortality and only 2 minor complications. Two patients survived 3 years and 1 is alive and free of disease 7 years from surgery. This technique should be considered before embarking on more perilous surgery such as "sleeve pneumonectomy," a procedure which still carries high mortality and morbidity rates and requires special equipment and intensive postoperative care.

Adult↗
PubMedDate not supplied

[Specific cytoplasmic receptors for steroid homones in benign and malignant breast diseases, in normal glandular tissue and pectoral muscle].

An improvement to the DCC (destran-coated charcoal) method for determining receptors for 17-beta-oestradiol, 5-alpha-dihydrotestosterone and progesterone in benign and malignant breast conditions, normal glandular tissue and muscular tissue is reported. Preliminary results on 16 malignant cancers and 4 fibrocystic mastopathies are discussed together with a critical review of the technique employed and the results obtained in hormone competition.

Adult↗
PubMedDate not supplied

Ileorectal anastomosis after colectomy for benign colon disease.

The immediate, or staged reconstruction of the digestive tract after total abdominal colectomy for benign bowel disease with an ileorectal anastomosis (I.R.A.) finds adamant supporters and opposers, thus confirming the controversial aspects of this procedure. The follow-up of 27 cases operated upon between 1973 and 1985, is discussed on the basis of clinical, radiological, endoscopic, histological and functional assessments.

Adolescent↗
PubMedDate not supplied

Toxic megacolon complicating ulcerative colitis and Crohn's disease.

The clinical, laboratory and radiological data of 17 cases of toxic megacolon (TM) complicating either ulcerative colitis (UC) or Crohn's disease (CD), referred to the Department of Clinica Chirurgica II of the University of Bologna in a twenty year-period, are reviewed. The surgical strategies and results are compared and discussed, and the mortality and morbidity considered along with the important advances in resuscitative medicine and the employment of total parenteral nutrition (TPN).

Adolescent↗
PubMedDate not supplied

The surgical management of Crohn's disease of the colon.

The authors analyze their experience in the management of 64 cases of Crohn's disease, located in the colon in 47 cases. The clinical and therapeutical aspects are discussed with particular attention to the surgical problems for which even today there is no general consensus of opinion especially when the colon is involved.

Adult↗
PubMedDate not supplied

A new approach in the management of Crohn's disease: observations in 20 consecutive cases.

Although the "modern history" of Crohn's disease dates back to 1932, the etiology is still nebulous, the medical treatment inefficient and resective surgery results in a high recurrence rate. Twenty consecutive patients with terminal ileitis underwent ileo-cecal resection and mesenteric-epiploonplasty to enhance collaterals and lymphatic drainage. This approach was advised by experimental observations (the ligation of colonic lymphatic ducts in rabbits), by the intraoperative use of optics to better appreciate the details of the diseased bowel before and after injecting dye and by the angiographic results in one patient. In rabbit experiments, the obliteration of lymphatic drainage led to Crohn's disease-like macroscopic and microscopic patterns, while diffusion of the dye injected in the diseased segment showed altered lymph flow. The angiographic study in one patient confirmed the presence of vascular anomalies. Direct observation through optics revealed large vessels in the serosa with milky contents and the oozing of sticky exudate. In the 8 patients who underwent this procedure over 5 years ago, there were no recurrences. We strongly believe in the vasculo-lymphatic etiology of Crohn's disease and in mesentery-epiploonplasty as the only actual indirect approach to resolve hemolymphatic obstructions.

Adolescent↗
PubMedDate not supplied

Surgery in Crohn's disease: when, where and why the recurrences?

One frustrating feature in the surgical management of Crohn's disease is the high recurrence rate which may lead to reoperation. It is common opinion that relapses occur haphazardly both in time and in site, and the causes remain unknown. When does a recurrence really arise after surgery? Is the site of recurrence determined by definite causes? Is there a relapsing factor? Between 1965 and 1995, 177 patients underwent surgery for Crohn's disease. The procedures performed in 145 cases were those popular at the time, while a recent series of 20 selected patients was managed following a new approach based on epiploonplasty. This strategy stems from the strong conviction that Crohn's disease is not a primary bowel disease but the result of stasis and superimposed infection due to a primary hemolymphatic disorder of the mesentery. The five-year recurrence rate was 62% in patients operated on according to standard procedures, while no recurrences were reported in the epiploonplasty group. Among 12 remaining patients with recurrent disease, two cases are reported in detail because they provide evidence in favor of the hemolymphatic theory. This study also maintains that recurrences, viewed with the hemolymphatic disorder in mind, occur immediately after surgery, while the superimposed intestinal inflammatory process and stricturing events may appear clinically at different time intervals during follow-up. The site of recurrences usually corresponds to the mesenteric region subjected to compression. Altered mesenteric microcirculation appears to be the true essence of the disease.

Adolescent↗