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Biomedical subjects

V Cervelli

Publications and source records attributed to V Cervelli.

At least 19 recordsLinked to original sources

Reconstruction of the nasal dorsum with autologous rib cartilage.

The authors present their experience with the correction of deformities of the nasal saddleback using rib cartilage grafts. They present a review of international literature on this topic, analyzing 33 patients selected from 452 cases of rhinoplasties performed between January 1990 and December 2004 at the Department of Plastic and Reconstructive Surgery of the University of Rome "Tor Vergata." Nasal saddleback is one of the most complicated defects to correct surgically. It can be a consequence of nasoethmoid-orbital fractures and is in this case associated with other evident signs like telecanthus, teleorbitism, or orbital dystopia. It can be also a consequence of surgical procedures in the nasal area where a loss of bone or septal cartilaginous support has occurred. They compare the techniques employed in the reconstruction and describe the advantage of the use of cartilage from the 11th rib and evaluate the results of an engineering analysis of tension forces on the rib cartilage. Of the total number of patients treated, good cosmetic results were obtained in 84% of the cases and excellent functional results in almost all of the cases (94%).

Adult↗

Obese and nonobese patients: complications of abdominoplasty.

We analyzed 80 patients who underwent abdominoplasty at the University of Tor Vergata "Policlinico Casilino", Rome to determine the effect of obesity on the incidence of complications after this surgery. The study patients were divided into 3 groups, obese, overweight, and normal weight, based on the degree to which their preoperative weights varied from their ideal body weight. A history of previous bariatric surgery was also analyzed to determine what impact that might have on subsequent abdominoplasty. Results showed that the records of 80 patients who underwent an abdominoplasty at University of Tor Vergata Policlinico indicated that 76% of obese patients had complications compared with the overweight and normal-weight patients, who had complication rates of 35% and 33%, respectively. Previous gastric bypass surgery had no significant effect on the incidence of postabdominoplasty complications. Based on these findings, the authors conclude that obesity at the time of abdominoplasty has a profound influence on the wound complication rate following surgery, regardless of any previous weight-reduction surgery.

Humans↗

Traumas of the middle skull base with TMJ involvement. Case report.

The authors report their experience with temporomandibular joint (TMJ) traumas involving breakage of the roof of the glenoid cavity, an infrequent event that occurs in those cases in which, as a result of the condylar neck not fracturing, the traumatic energy is transmitted to the middle skull base. As the literature contains no valid series for establishing standardized protocols for the treatment of these fractures, we propose our own orthopedic-functional approach. The patient observed by us had suffered a cranio-facial trauma and presented the classical symptoms and signs of TMJ traumas and complete bilateral Bell paralysis. He was subjected to a CAT scan and then to 2-stage treatment consisting of functional rest with liquid diet followed by physiotherapy. An almost total recovery in TMJ function was observed after 1 month. At 1-year follow-up the facial paralysis had resolved completely. On the basis of our experience, breakages of the glenoid cavity can be compared, in terms of treatment procedure, to intracapsular fractures of the TMJ with surgery confined to cases of ankylosis sequelae. To avoid the onset of ankylosis careful control of clinical, functional and radiological follow-up is required.

Adult↗

[New view in the mammary asymmetry treatments].

AIM: Breast asymmetry is a huge chapter of breast abnormalities. Surgical therapy is the exclusive one. The breast of women can vary in shape, volume and position, thus creating esthetic, social and psychological problems. METHODS: We classified breast asymmetry into 6 categories and then we treated them with different surgical techniques: reduction mammaplasty according to Planas; augmentation mammaplasty with prosthesis; grafts or both; ultimately mamma-prosthesis (association of mastopexy and prosthesis). We obtained satisfactory esthetic results often with one surgery procedure. Rarely we performed 2 or more procedures of symmetry. We treated 77 patients suffering from breast asymmetry. We excluded in this study the giant-mammary asymmetry (anomaly determined by severe and asymmetric mammary hypertrophy). RESULTS: We found a low number of complications at short and long term. These results are likely due to the ability of the surgeon in the appropriated preoperative evaluation of the patients and of their expectancy and correct surgical techniques. CONCLUSIONS: We tried to obtain 3 results: shape and position of the sick breast as same as possible to the contralateral breast and less evident scars located in hidden regions.

Adolescent↗

Sublingual ranula: report of a submandibular clinical case.

Ranula is a raised mucocele on the oral floor. When the mucocele extends and passes the sublingual space and invades the submandibular space it may be called ''plunging ranula''. Its etiology is not completely known. Our clinical case is a clear example: a 10-year old formation, not painful, developed during several years and originally of small dimension located in the sublingual region. The purpose of this study is to underline that the surgical treatment of choice, in these clinical situations, is the drainage of the cavity and marsupialization rather than a radical removal.

Female↗

Reconstruction of partially amputated external ear with costal cartilage graft: case report.

Many causes are responsible for secondary anomalies of the outer ear, such as: car accidents, sport- or work-related accidents, assaults, bites from animals or humans, benign or malignant tumours, burns and the effects of surgical interventions of the ear (plastic surgery on the ear or attempts at correction of primary malformations of the ear). The anatomical complexity of the ear makes its reconstruction particularly complicated with post-operative results that are often disappointing. The Authors describe their experience in the reconstruction of a partially amputated outer ear following a dog bite. The therapeutic protocol required various surgical stages. Initially, a cutaneous expander was applied at the level of the mastoid in order to ensure a sufficient quantity of local skin. The second stage was to remove cartilage from the ribs, followed by construction of a cartilaginous model of the ear and its insertion into the subcutaneous mastoid region after removal of the cutaneous expander and any residual ear cartilage. The last stage was to separate the neo-formed outer ear from the mastoid skin with the insertion of a cartilage graft to the posterior region of the reconstructed ear. This graft was covered by the occipital fascia rotated at 180 degrees and by a skin graft removed from the pubis. The postoperative result was satisfactory with recuperation of a good aesthetic appearance of the ear. Aim of the present report is to describe the surgical technique employed in the reconstruction of secondary anomalies of the ear and to highlight errors committed during this procedure. These considerations have allowed us to stress some fundamental elements in the reconstruction of the ear. In particular, the watershed was the awareness that we had to create a cartilaginous model that respected, as far as possible, the anatomy of the outer ear with all its ridges, trenches and cavities. This as well as ensuring a sufficient quantity of local skin in order to cover the cartilaginous graft and, therefore, reduce the risk of exposing the cartilage and subsequent infection, to guarantee an optimal end result.

Adult↗

Dual X-ray absorptiometry for estimating the volume of the soft tissue in the human skull.

The aim of this study was to analyze the relationship between soft and hard tissue measurements of the head so as to identify the range of soft tissues parameters that should be applied in forensic facial approximation. The study was performed on 85 healthy female volunteers with an age range of 35-45 years. Total and regional body composition analysis was undertaken with subjects in a recumbent position using dual X-ray absorptiometry. The head was defined from the inferior part of the mandible to the vertex. We found the range of total head soft tissue weight to be between 3.02 and 4.96 kg. The quantity of soft tissue applicable to Caucasian female subjects in good health was estimated by subtracting the weight of the brain (approximately 1.17 kg in a typical adult female) from these values. Thus, the minimum and maximum values of the soft tissue are 1.85 and 3.79 kg, respectively.

Absorptiometry, Photon↗

Body composition differences in adolescent female athletes and anorexic patients.

Osteopenia is a frequent complication affecting adolescent girls with anorexia nervosa (AN). Moreover, female athletes suffering from eating disorders can be affected by premature osteoporotic fractures. The aim of this study was to examine bone mineral content (BMC) and bone mineral density (BMD) in three groups of adolescent females. Anthropometric and body composition measurements were performed on 22 adolescent females (age+/-SD=15.6+/-1.4 years) divided into groups: athletes ( n=8), patients with AN ( n=8) and age-height matched control subjects ( n=6). Body weight and body mass index were significantly lower ( p<0.01) in athletes and AN patients compared with healthy controls. BMC and BMD were lower ( p<0.01) for AN patients and athletes compared with healthy controls; AN patients had the lowest BMC value. Athletes had higher lean body mass values compared with AN patients and healthy controls. These results suggest that the effects of eating disorders, specifically BMC loss, could be attenuated by physical activity.

Adipose Tissue↗

Predicting fat-free mass in children using bioimpedance analysis.

Body composition assessment is a useful procedure for the study of nutritional status and water distribution. In adults, it is a predictor of morbidity and mortality, since body fatness is associated with risk factors for cardiovascular disease. Bioelectric impedance analysis (BIA) is a simple, safe, and inexpensive method for assessment of body composition both in pediatric and adult subjects. The aim of our study was to validate the impedance index, ZI (H(2)/Z, height in cm(2)/impedance), as a predictor factor of fatfree mass (FFM) and fat mass (FM) in a sample ( n=75) of normal children. Dual-energy X-ray absorptiometry (DXA) was chosen as reference method. Despite some minor bias, DXAis considerably less expensive and easier to administer in pediatric subjects than other established gold standard reference methods for assessing body composition. ZI values were highly correlated with FFM measured with DXA. The following equations were obtained from the regression analysis: (a). male subjects, FFM(DXA)=0.6375 (ZI)+5.9913, r(2)=0.897, p<0.0001; (b). female subjects, FFM(DXA)=0.7597 (ZI)+ 3.5853, r(2)=0.903, p<0.0001. These data support the notion that BIA alone can be used as a surrogate to measure FFM in a pediatric sample.

Absorptiometry, Photon↗

How fat is obese?

The aim of the study was a comparison between body fat measurements and body mass index. We analyzed the data of 890 subjects, 596 females and 294 males, ranging in age from 18 to 83 years, in body mass index (BMI) from 14 to 54 kg/m(2), and in body fat percentage (BF%) from 4% to 57%. A considerable number of subjects, both males and females, could not be classified as obese based on their BMI alone. Such a misclassification is undesirable, especially in general practice, and it calls for diagnostic criteria other than the BMI alone to be used for obesity.

Adipose Tissue↗

[Diabetic foot. Physiopathology, clinical aspects, and recent therapeutic approaches].

Diabetic foot is a complication of diabetes mellitus occurring in 15% of patients that is of specific surgical interest. Over the past few years, preventive measures and the use of new therapeutic resources has reduced the number of patients undergoing demolitive surgery. The authors present a concise but at the same time sufficiently detailed picture of modern knowledge of the physiopathology, clinical aspects and current therapeutic guidelines for diabetic foot. In particular, they analyse the validity of various forms of complementary treatment to surgery, including techniques to stimulate tissue repair processes, hyperbaric oxygen therapy and laser therapy, and they underline the importance of using a multidisciplinary approach to this pathology. To this end, they review all the articles on the subject reported on Medline from 1992 to June 1998, presenting and commenting on the most significant results.

Diabetic Foot↗

[Diverticulosis of the gallbladder. A case report and review of the literature].

We report a case of diffuse diverticulosis of the gallbladder in a 32 year old patient, who presents epigastric pains and decayed general conditions. With the suspicion of a primitive tumor of the gallbladder, we make a cholecystectomy and the intraoperative histological examination shows a "diffuse diverticulosis of the gallbladder wall"; it displays micro-stones inside diverticulums, too. The patient, after the surgical treatment, has no problem and he gets back to his normal weight. The literature shows the rarity of this disease; its etiopathogenesis is connected with congenital factors. In our opinion, the many terms used (cholecystitis glandularis proliferans, hypertrophic, adenomyomatosis) to define those conditions are not appropriate for our case but rather for the gallbladder's chronic inflammation characterized by the Rokitansky-Ashoff sinuses.

Adult↗

[Mechanical physiopathology of remodeling peri-implant bone. The role of cytokine].

For a number of years titanium osteointegrated implants have represented a major step forward in dentistry, plastic and maxillofacial surgery, providing a lively stimulus to research both in their application and in the experimental field. The study of osteointegration has led to a more detailed knowledge of bone remodelling regulation mechanisms and the biological mediators involved. In this review the authors examine the role played by cytokines in the homeostasis of bone tissue, paying special reference to the phase of osteoclast activation and its possible effects on peri-implant bone resorption. The authors focus in particular on the effects of interleukin-6 (IL-6) as an important osteotropic factor and a hypothetical target on which to act in order to modulate its effects for therapeutical purposes.

Bone Regeneration↗

Mechanisms of bone resorption: analysis of proinflammatory cytokines in peritoneal macrophages from titanium implant--an experimental design.

Cytokines, and interleukin-6 in particular, are inflammatory peptide mediators that are extensively studied as regulators of bone tissue homeostasis. They seem to be involved in osteoclast activation and bone resorption and probably play a role in osseointegrated implant rejection. In this study we investigate the ability of titanium implants to cause an imbalance in the homeostatic equilibrium of cytokines using the peritoneal cavity of DB-A2 mice as a model. The inflammatory response was evaluated as a messenger ribonucleic acid expression determined by the semiquantitative reverse transcriptase--polymerase chain reaction technique in peritoneal macrophages from titanium-implanted mice. Interleukin-6 release was detected by a specific quantitative enzyme-linked immunosorbent assay. Our results have shown that titanium implants do not significantly stimulate the proinflammatory cytokine system compared to the control group. The enzyme-linked immunosorbent assay test confirms, after a peak in secretion at day 1 compared with basal levels, a clear decrease in interleukin-6 at basal levels on following control at 6 and 9 days after implantation. The study of the interaction between implanted biomaterials and inflammatory mediators seems to be very promising. Perhaps a better understanding of the mechanisms of bone resorption could lead to finding a new clinical solution for patients with osseointegrated implant rejection.

Animals↗

[Cultured human urothelium. Possible application in reconstructive surgery of the urinary tract].

The authors focus on and analyse a number of problems linked to urinary tract reconstruction, with special reference to urethral surgery in patients suffering from hypospadias. After having examined a number of approaches used over this period, the authors underline the possible new applications and future lines of research offered by cell culture techniques in the fields of urology and plastic surgery.

Cells, Cultured↗

SPECT in the long-term evaluation of osteointegration in intraoral and extraoral implantology.

Scintigraphic methods used in intraoral and extraoral implantology allow the evaluation of bone metabolism in the peri-implant zones, providing anatomic images and functional dynamics information on the osteointegration process. Twenty-five patients who underwent implantation operations for the application of intra- and extraoral prostheses were studied using technetium 99 m single photon emission computed tomographic (SPECT) procedures to evaluate osteointegration dynamics at 3 weeks, and 3, 6, 12, and 24 months. The study demonstrates that radiation emission peaks 3 weeks after surgery with the maximal bone remodeling activity and 6 months after surgery after the functional loading of the implants only in intraoral fixtures. High uptake past the eighth month after surgery has never been detected and must be considered abnormal. SPECT offers the possibility of obtaining a three-dimensional reconstruction of the photon emission of selected structures. The use of these nuclear medicine methods in addition to traditional-type radiological procedures introduces new possibilities, although still in the clinical experimentation phase, for early diagnosis and inserted implant prognosis.

Adolescent↗