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Biomedical subjects

V Perrone

Publications and source records attributed to V Perrone.

12 recordsLinked to original sources
PubMed2004

The use of extracorporeal photopheresis for allograft rejection in liver transplant recipients.

BACKGROUND: Originally introduced for cutaneous T-cell lymphomas and autoimmune diseases, extracorporeal photopheresis (ECP) has been proven effective to reverse allograft rejection. The aim of the present work was to show the results of a single-center experience with ECP for the treatment of biopsy-proven rejection in selected liver transplant (LT) recipients. PATIENTS AND METHODS: A retrospective review of five LT patients (M:F=4:1; median age 51 years) undergoing ECP for biopsy-proven allograft rejection between January 1996 and December 2003. In this period 476 LT were performed on 441 patients. RESULTS: The indications for LT were three cases of HCV-related cirrhosis, complicated by hepatocellular carcinoma in two; one HBV-HDV-alcoholic cirrhosis; and one fulminant HBV hepatitis. All patients received calcineurin-inhibitor (CNI)-based immunosuppression with induction using anti-IL2R monoclonal antibodies. Indications for ECP were: ductopenic rejection in one patient with HCV recurrence; steroid-resistant acute rejection in two; acute rejection in a major ABO-mismatched liver graft; and one acute rejection in a patient with a proven allergy to steroids. The median interval from LT to inception of ECP was 43 days. The median number of ECP sessions per patient was 20. During the course of ECP, two patients tested positive for CMV antigenemia, associated in one case with bacterial pneumonia. All patients tolerated ECP and there were no procedure-related complications. At a median follow-up of 7.9 months after start of ECP, neither rejection relapses nor HCV/HBV recurrences have been observed. Three patients are off ECP with complete reversal and low-dose immunosuppression. Two patients are still receiving ECP with full-dose immunosuppression: one has achieved normal liver function but ECP is indicated due to a major ABO-incompatible liver graft, while the other patient's liver functions have not yet returned to baseline values.

Adult↗
PubMed2003

Surgical complications after liver transplantation.

AIM: The number of liver transplantations in Italy has steadily increased over the last 10 years as a result of the use of donors aged more than 60 years. The use of organs with a reduced functional reserve has been compensated for by improvements in immunosuppressive therapy, surgical techniques and the management of postoperative complications. This article describes the incidence and treatment of the main surgical complications after liver transplantation. METHODS: Between January 1996 and June 2003, 398 patients received 430 transplants at our Centre. Thirty-seven early relaparotomies were performed (8.6%), including 12 retransplantation (2.8%). The 1-, 3- and 5-year actuarial survival of the patients was 79.8%, 72.2% and 67.5%, and that of the grafts was 75.9%, 68% and 63.4%. Perioperative mortality was 10.5% (with no intraoperative deaths). RESULTS: The overall incidence of biliary complications was 31.6%, 9.1% of which were due to the removal of the Kehr tube. There were 42 (9.8%) anastomotic stenoses, 5 (1.2%) extra-anastomotic stenoses, 1 (0.2%) anastomotic leak, 5 (1.2%) extra-anastomotic leaks, and 19 (4.4%) ischemic-type biliary lesions. The overall incidence of vascular complications was 6.9%: 7 (1.6%) cases of hepatic artery thrombosis, 17 (4.0%) arterial stenoses, 1 (0.2%) arterial pseudoaneurysm, 4 (0.9%) cases of portal thromboses and 1 (0.2%) case of caval laminar thrombosis. Eight patients (1.9%) developed massive and persistent post-transplant ascites and/or hydrothorax. CONCLUSION: The use of donors aged more than 60 years makes it possible to maintain high standards of patient and graft survival that is not only due to the optimisation of immunosuppressive protocols, but also to improvements in surgical techniques, intensive care and the management of surgical complications.

Adolescent↗
PubMed2000

A Lost Realm in the Internal Domains of the Betic-Rif Orogen (Spain and Morocco): Evidence from Conglomerates and Consequences for Alpine Geodynamic Evolution.

The Malaguide-Ghomaride Complex is capped by Upper Oligocene-Aquitanian clastic deposits postdating early Alpine orogenesis but predating the main tectonic-metamorphic evolution, end of nappe emplacement, unroofing, and exhumation of the metamorphic units of the Betic-Rif Orogen. Two conglomerate intervals within these deposits are characterized by clasts of sedimentary, epimetamorphic, and mafic volcanic rocks derived from Malaguide-Ghomaride units and by clasts of acidic magmatic and orthogneissic rocks of unknown provenance, here studied. Magmatic rocks originated from late-Variscan two-mica cordierite-bearing granitoids and, subordinately, from aplitic dikes. Orthogneisses derive from similar plutonic rocks but are affected by an Alpine metamorphic overprint evolving from greenschist (T=510&j0;-530 degrees C and P=5-6 kbar) to low-temperature amphibolite facies (T>550&j0;C and P<3 kbar). Such a plutonic rock suite is unknown in any Betic-Rif unit or in the basement of the Alboran Sea, and the metamorphic evolution in the orthogneisses is different from (and older than) that of Alpujarride-Sebtide rocks to which they were formerly ascribed. Magmatic and metamorphic rocks very similar to those studied characterize the basements of some Kabylia and Calabria-Peloritani units. Therefore, the source area is a currently lost continental-crust realm of Calabria-Peloritani-Kabylia type, located to the ESE of the Malaguide-Ghomaride Domain and affected by a pre-latest Oligocene Alpine metamorphism. Increasingly active tectonics transformed this realm into rising areas from which erosion fed small subsiding synorogenic basins formed on the Malaguide-Ghomaride Complex. This provenance analysis demonstrates that all these domains constituted a single continental-crust block until Aquitanian-Burdigalian times, before its dispersal around nascent western Mediterranean basins.

Journal Article↗
PubMed1999

Response to polyetherimide based composite materials implanted in muscle and in bone.

The in-vivo response to a composite material obtained with polyetherimide (PEI) reinforced with carbon/glass fibers was investigated by histological methods by implanting cylinders in muscle and in bone of the New Zealand White rabbit. A common metallic alloy, widely used in orthopaedic surgery, was used as control (Stellite). The aim of the study was to analyze the biological response towards the surface of the material. Composite implants and metallic implants did not induce adverse or inflammatory reactions. The morphological picture produced was similar, in muscle and in bone, for both materials. In muscle, cylinders were confined by an extremely thin fibrous layer and the overall appearance of the muscular tissue was normal. In bone, cylinders were confined by a nearly annular rim of newly formed bone. From these data it is possible to derive that the response to PEI-based composite material is comparable with the response to metallic substrate and, then, the material can be suitable for clinical application.

Journal Article↗
PubMed1994

[Ultrasonic liquid medium for lipo-emulsification. An experimental study].

The technique of ultrasonic lipo-emulsification is currently gaining increasing support. This method consists in the dissolution of human adipose tissue using ultrasound generated by a special appliance and transmitted using (mini-invasive) titanium probes inserted into the subcutis. This procedure is preceded by the infiltration of subcutaneous fat using specially studied hypotonic solutions. On the basis of their previous experience and using data reported in the literature, the authors carried out a study to establish whether among the solutions routinely used there are alternative saline solutions which might enhance the lipolytic efficiency of ultrasound or allow possible saving in terms of time and money. Samples of ex-vivo subcutaneous adipose tissue weighing 5 g were exposed to ultrasonic energy at a frequency of 19800 Hz and an output of 65 Watt until fully dissolved. Prior to this the samples were immersed in a saline solution commonly used in clinical practice for perfusion at a different osmotic pressure. The authors succeeded in identifying saline solutions able to mediate the lipolytic ultrasonic action with greater efficiency than the solutions currently used by other authors.

Adipose Tissue↗
PubMedDate not supplied

The effectiveness of the circular external fixator in the treatment of post-traumatic of the tibia nonunion.

Authors report the results they obtained when the Ilizarov circular external fixator was used for the treatment of post-traumatic nonunion of the tibia. A total of 20 patients were treated. Of these 12 had been submitted to treatment elsewhere and using other methods; 9 presented with septic nonunion; 10 revealed radiographic findings of atrophic nonunion, and 10 were hypertrophic. There was axial deviation in 18 patients. The results of treatment were always: healing of the nonunion; functional recovery of the limb; correction of leg length discrepancy; recovery of the mechanical axis. The mean stabilization time (days between the application and the removal of the fixator) was 138 days. The Ilizarov method thus proved that it was effective in the treatment of post-traumatic nonunion of the tibia where other types of treatment had failed.

Adolescent↗