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41.
J Albert L Franzén M Jansson G Scarlatti P K Kataaha E Katabira F Mubiro M Ryd?ker P Rossi U Pettersson 《Virology》1992,190(2):674-681
The third variable (V3) loop of the human immunodeficiency virus type 1 (HIV-1) envelope protein is an important determinant for virus neutralization and cell tropism. V3 loop sequences from uncultured lymphocytes obtained in 1990 from 22 Ugandan HIV-1-infected patients could, with the exception of two patients' sequences, be divided into two groups (A and B) on the basis the V3 loop size and sequence. The V3 loop consensus sequences from both groups showed a high degree of homology to a U.S./European consensus, a characteristic also reflected by the results of peptide serology. In the case of group B the difference in sequence was only five amino acids. In contrast, the V3-flanking regions for both groups showed greater homology to an earlier (1986/1987) Ugandan consensus. The discovery of these two new Ugandan V3 loop genotypes, which are closely related to the U.S./European consensus, has implications for the understanding of the evolution of HIV-1 and for the future design of a vaccine for use in Africa. 相似文献
42.
Agenesis of common carotid artery is rare and no report of stenting procedures (carotid artery stenting) for associated stenosis of the internal carotid have been published. We report a case of internal carotid stenosis associated with this anomaly. A 73-year-old male with left internal carotid artery originating from the arch, with significant stenosis, was referred to us. Wallstent was deployed with success. Carotid artery stenting should be reserved to uncomplicated arch anatomy and plaques with low fragmentation risk. 相似文献
43.
44.
Treatment of Hemorrhoids in Day Surgery: Stapled Hemorrhoidopexy vs Milligan–Morgan Hemorrhoidectomy
Vito Maria Stolfi Pierpaolo Sileri Chiara Micossi Isabella Carbonaro Marco Venza Paolo Gentileschi Piero Rossi Alessandro Falchetti Achille Gaspari 《Journal of gastrointestinal surgery》2008,12(5):795-801
Background Recently, it has been demonstrated that surgical treatment of hemorrhoids in a day-care basis is possible and safe. The aim
of this study was to compare the Longo stapled hemorrhoidopexy (SH) and the Milligan–Morgan hemorrhoidectomy (MMH).
Methods One hundred seventy one patients (95 cases in SH group and 76 cases in MMH group) entered the study: 83 cases were III degree
hemorrhoids, 88 IV degree. A priori and a post hoc power analysis were performed. Results, prospectively collected, were compared
using chi squared test and student t test. Visual analog scale was used for pain evaluation. Postoperative pain, duration of pain, wound secretion, bleeding,
resumption of a normal lifestyle, and postoperative complication were evaluated.
Results Surgical time was 28.41 ± 10.78 for MMH and 28.30 ± 13.28 min in SH (P = 0.94). Postoperative pain was not different between MMH and SH during the first two postoperative days (4.73 ± 2.91 vs
5.1 ± 3.048; P = 0.4), during the following 6 days, patients treated with SH had less pain (4.63 ± 2.04 in MMH vs 3.60 ± 2.35 in SH; P = 0.006). In the SH group, seven patients needed further hospital stay for complicated course. SH showed higher incidence
of anal fissure compared with MMH (6.3% vs 0%; P = 0.025) but no differences in urinary retention, anal stricture, urgency, or anal hemorrhage.
Conclusions This study confirms that SH is associated with less postoperative pain and shorter postoperative symptoms, compared with MMH.
SH may be a viable addition to the therapy for hemorrhoids with some advantages in early postoperative pain and some disadvantages
in postoperative complications and costs. 相似文献
45.
The role of JOA score as an indication for surgical or conservative treatment of symptomatic degenerative lumbar spinal stenosis 总被引:1,自引:0,他引:1
G. Costanzo P. Cellocco A. Di Francesco C. Rossi 《Journal of orthopaedics and traumatology》2005,6(3):150-153
Abstract
The aim of this study was to evaluate the short- to medium-term results (up to 2 years) of conservative and surgical treatments
of patients with symptomatic lumbar stenosis. To our knowledge, no previous study has provided strict indications for conservative
or surgical treatment. We retrospectively studied 184 patients, who were divided into 3 groups according to JOA (Japanese
Orthopaedic Association) score. A cutoff JOA score was arbitrarily fixed at 7.
Patients with a score ≤7 (n=12; group A) underwent surgery, while patients with a score >7 (n=172) were conservatively treated.
Group A included patients surgically treated within two months from diagnosis. Group B consisted of 144 patients who received
conservative treatment, while group C (28 patients) represented patients who underwent surgery after a period of failed conservative
treatment. The outcomes of surgical and conservative treatments were evaluated after 12 and 24 months, and were rated as satisfactory,
not totally satisfactory, not satisfactory or totally unsatisfactory. Conservative treatment consisted of physical, orthotic
and drug therapy, whereas surgical treatment included spinal decompression and instrumentation (if indicated), either rigidly
or dynamically performed. Surgery was indicated in 22% of all patients and we obtained excellent results in 85% of them. Operative
treatment provides excellent results for patients with severe clinical presentation (JOA score ≤7), while individuals with
mild to moderate spinal stenosis (JOA score >7) should receive conservative treatment. 相似文献
46.
Christian Casali Alessandro Stefani Pamela Natali Giulio Rossi Uliano Morandi 《European journal of cardio-thoracic surgery》2005,28(1):33-38
OBJECTIVE: Patients with non-small cell lung cancer (NSCLC) with metastases to ipsilateral mediastinal lymph nodes (N2) are an heterogeneous group of patients as regard to prognosis and treatment. Indication and timing of surgery remain controversial. The present study investigates the prognostic factors, in order to identify homogenous subgroups of patients. METHODS: Histologically proven N2-NSCLC patients, who underwent a complete surgical resection were retrospectively reviewed. Clinical and pathological features were reported and analyzed, and survival study was performed. RESULTS: One hundred eighty-three patients were analyzed. Overall 1.3 and 5 years survival rates were, respectively, 70, 35 and 20%, with a median survival time of 24 months. Univariate analysis showed a significant better prognosis for: incidental N2 respect to clinical N2 (5-years 35.4 vs 17.4%); single level lymph node involvement respect to multiple levels (5-years 23.8 vs 14.7%); metastases to superior mediastinal or aortic nodes respect to lower mediastinal nodes (5-years 32 and 24.3 vs 16.3%); right upper lobe tumors with superior mediastinal nodes and left upper lobe tumors with aortic nodes respect to lower lobes tumors with lower mediastinal nodes (5-years 31.8 and 26.9 vs 15.7%). Skip metastases had not a significant survival advantage respect to continuous lymphatic spread. N2 clinical status, the number of levels involved and the two specific patterns of lymphatic spread resulted significant prognostic factors at multivariate analysis. CONCLUSIONS: Clinical N2 status, number of lymph nodes levels involved and specific patterns of lymphatic spread identify homogenous subgroups of patients that can be proposed for different therapeutic strategies. 相似文献
47.
48.
AE Castellano G Micieli P Bellantonio MG Buzzi S Marcheselli F Pompeo F Rossi G Nappi 《Cephalalgia : an international journal of headache》1998,18(9):622-630
Intracerebral vascular reactivity induced by the nitric oxide (NO) donor isosorbide dinitrate (IDN, 5 mg sublingually) is more major and longer-lasting in migraine patients who develop delayed headache in response to the drug. The headache is purportedly due to neuronally-mediated vascular mechanisms. Indomethacin inhibits prostaglandin synthesis, which is involved in NO generation. Indomethacin also decreases cerebral blood flow by constricting precapillary resistance vessels. In the present study, the hemodynamic effects of indomethacin were evaluated in migraine patients and healthy controls by means of transcranial Doppler monitoring. Indomethacin caused a significant decrease in mean flow velocity in the middle cerebral artery. This was an additional effect to the mean velocity decrease induced by IDN. The interactions between the two drugs suggest that their effects on cerebral hemodynamics (and pain) may be of relevance both in understanding the role of NO in migraine pathogenesis and in evaluating symptomatic treatments for migraine attacks. 相似文献
49.
Laparoscopic bile duct injuries. Risk factors, recognition, and repair. 总被引:18,自引:0,他引:18
R L Rossi W J Schirmer J W Braasch L B Sanders J L Munson 《Archives of surgery (Chicago, Ill. : 1960)》1992,127(5):596-601; discussion 601-2
Records of 11 patients undergoing biliary reconstruction after laparoscopic cholecystectomy are reviewed. Ductal injuries resulted from failure to define the anatomy of Calot's triangle. Risk factors include scarring, acute cholecystitis, and obesity. Presenting findings included anorexia, ileus, failure to thrive, pain, ascites, and jaundice. All patients required hepaticojejunostomies, which were multiple and above the hepatic bifurcation in four patients. Given the extensive nature of these injuries and the frequent need for intrahepatic anastomosis and early stenosis of repairs by referring physicians, we recommend reconstruction be undertaken by an experienced hepatobiliary surgeon. To avoid injuries, a greater appreciation of risk factors and anatomic distortion and variance and strict adherence to principles of dissection and identification of anatomic structures are suggested. The use of cholangiography and a low threshold for conversion to the open procedure are advised. 相似文献
50.