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1.
P Gallinaro E Indemini G Tabasso G Massazza 《La Chirurgia degli Organi di Movimento》1992,77(1):61-63
Stenosis of the nerve root canal caused by isolated resorption of a lumbar disc is a frequently observed pathology, but one about which the orthopaedist still knows relatively little. Henry Crock was the first to reveal its principal pathogenetic factor, disc resorption, and to accurately describe the syndrome and its surgical treatment. A total of 22 patients operated according to Henry Crock's indications and followed-up after 2 years were reviewed. In 20 cases decompression alone was performed, while in 2 cases anterior fusion and MOSS instrumentation were associated. Of the 22 patients submitted to decompression 17 revealed complete regression of pain. Three cases failed: 1 patient had previously been treated with chymopapain, while 3 are awaiting anterior fusion to treat persistent lumbar pain. Follow-up is not sufficient for the two patients submitted to anterior fusion. 相似文献
2.
P. Berloco R. Pretagostini L. Poli M. Caricato A. Speziale D. Cozzi L. Gallinaro D. Alfani R. Cortesini 《Transplant international》1994,7(S1):314-317
Abstract The use of unrelated living donors in kidney transplantation is still controversial but many transplant centres have accepted this procedure. The main argument against this approach is usually an ethical one. Because of this, at our institution we accept biologically unrelated donors only if they have an emotional closeness to the recipient. From January 1983 to October 1993, out of 654 kidney transplantations we performed at our institution, 364 kidney allografts were from living donors. Of these living donors, 245 were first-degree relatives of the recipient (LRD) while 119 were unrelated (LURD); 100 cases were spouses-wife to husband in 76 cases and husband to wife in 24 cases Statistical analysis of the results (chisquare) revealed actuarial patient and graft survival rates of 89.8% and 86.8% at 1 year, 82.9% and 72.3% at 5 years and 12.3% and 60.3% at 9 years, respectively. In our series, the result of living donor kidney transplantation in this group were similar to those obtained in the LRD group, while they were significantly better than those from cadaver donors (P = 0.003). In conclusion, cadaver organs given the shortage of kidney transplantation between spouses may be a good alternative and can be performed successfully, providing a "gift of life" for both the patient and the family. 相似文献
3.
The incidence of second primary lung cancer (SPLC) seems to have increased in recent years. In our series that included more than 4000 patients with lung cancer and 1600 operations, we observed 26 cases of SPLC up until June 1999. We considered the standard criteria accepted by most authors for the selection. Characteristics of patients and tumors at the time of the first operation were compared with the statistical data of our general series. Age, sex, performance status and smoking were all considered, as well as cancer site, histology, stage and type of first surgical operation. No significant independent factor could be identified for the prediction of a new tumor at that time. A second operation was possible in 16 cases: two patients died in the postoperative period, two survived for 12 and 24 months, respectively, 12 are still alive 8-87 months after the new resection. The high rate of surgical cases (16/26 = 62%) and a good survival rate is clearly correlated with an early diagnosis of SPLC. 相似文献
4.
Geltrude Mingrone MD. PhD. Dr. Aldo V. Greco MD Giuseppe Benedetti MD Esmeralda Capristo MD Roberto Semeraro MD Giorgio Zoli MD Giovanni Gasbarrini MD 《Digestive diseases and sciences》1996,41(1):72-76
Resting energy expenditure (REE) was measured by indirect calorimetry and body composition was assessed by both direct (bioimpedance) and indirect (anthropometry) methods in 20 hospitalized patients with biopsy-proven ileal Crohn's disease and in a group of 16 healthy volunteers matched for sex, age, and height with the patient group. The Crohn's disease activity index was below 120 in all patients studied. who were treated with a low dose of corticosteroids (0.2–0.3 mg/kg body wt of prednisone). The average weight of Crohn's patients was signficantly lower than that of controls (55.70 vs 70.50 kg,P<0.001) due to both lower fat mass (9.97 vs 18.30 kg,P<0.001) and lower lean body mass (45.72 vs 52.20 kg,P<0.02). The average REE was significantly higher in the control group (1785.42±7.503 vs 1559.1±48.39 kcal/day,P<0.001). However, these differences disappeared when REE was normalized by lean body mass (LBM) (34.49±2.56 vs 34.704±3.75 kcal/kg LBMP=NS). The nonprotein respiratory quotient was significantly lower in the patient group (0.823±0.031 vs 0.882±0.012.P<0.025), indicating an increased lipid oxidation. This increased lipid oxidation might explain the reduced fat stores found in the group of Crohn's patients, suggesting also that a sufficiently lipid-rich diet could be useful in their nutritional management. 相似文献
5.
Geltrude Mingrone Lidia Castagneto‐Gissey Katherine Macé 《British journal of clinical pharmacology》2013,75(3):671-676
Even‐number, medium‐chain dicarboxylic acids (DAs), naturally occurring in higher plants, are a promising alternative energy substrate. Unlike the homologous fatty acids, DAs are soluble in water as salts. They are β‐oxidized, providing acetyl‐CoA and succinyl‐CoA, the latter being an intermediate of the tricarboxylic acid cycle. Sebacic acid and dodecanedioic acid, DAs with 10 and 12 carbon atoms respectively, provide 6.6 and 7.2 kcal g−1 each; therefore, their energy density is intermediate between glucose and fatty acids. Dicarboxylic acids have been proved to be safe in both experimental animals and humans, and their use has recently been proposed in diabetes. Studies in animals and humans with type 2 diabetes showed that oral administration of sebacic acid improved glycaemic control, probably by enhancing insulin sensitivity, and reduced hepatic gluconeogenesis and glucose output. Moreover, dodecanedioic acid intake reduced muscle fatigue during exercise in subjects with type 2 diabetes, suggesting an improvement of energy utilization and ‘metabolic flexibility’. In this article, we review the natural sources of DAs, their fate in animals and humans and their effect in improving glucose metabolism in type 2 diabetes. 相似文献
6.
A Casonato F Fabris E Pontara M G Cattini N Zocca L Gallinaro A Girolami A Pagnan 《Clinical and applied thrombosis/hemostasis》2006,12(3):296-304
Thrombotic thrombocytopenic purpura (TTP) is characterized by intravascular thrombosis leading to consumption of large or unusually large von Willebrand factor (VWF) multimers. The usefulness of VWF collagen binding (VWF:CB) assay was assessed in detecting the decrease/absence of large VWF multimers or the presence of abnormally large forms in patients with TTP. Nine patients with TTP were studied during the acute phase of the disorder and the absence of large VWF multimers was demonstrated by means of the VWF:CB assay. These findings were confirmed by VWF multimer pattern analysis; VWF:CB deficiency appeared to correlate with abnormalities in large VWF multimers. The diagnostic potency of VWF:CB was especially evident when the values were expressed as VWF:CB/VWF:Ag ratio. VWF:CB was also used during the follow-up of the disorder to document improvement or restoration of large VWF multimers. VWF:CB was able to detect the absence or decrease of large VWF multimers better than VWF ristocetin cofactor (VWF:RCo); in fact, VWF:CB was defective when large VWF multimers persisted to be decreased, in contrast with what observed with VWF:RCo. In conclusion, VWF:CB is a simple test that appears to be useful, together with clinical symptoms and reduced platelet count, for the diagnosis and follow-up of TTP. 相似文献
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9.
Twenty-five percent of patients undergoing surgery for acute complicated diverticulitis represent emergencies. This condition is currently treated by colonic resection with primary anastomosis with or without colostomy, or by a Hartmann operation. We report on our experience with 52 consecutive patients with generalized peritonitis (8 cases), peri- and paracolonic abscesses (19 cases), severe pelvic abscesses (12 cases) and multiple abscesses with visceral fistulas (13 cases). All patients had emergency surgery. In 50/52 patients (96.2%) we performed a colonic resection with primary anastomosis using a mechanical stapler and in 2/52 a Hartmann operation. The overall mortality rate was 5.8%. The morbidity rate was 22% with 9 anastomotic leakages. A diverting colostomy was constructed in 16 patients and opened in only 8 patients. In 4 cases a parastomal hernia occurred after late closure and reduction of the colostomy. This data suggest that colonic resection with primary anastomosis, even without colostomy, is a safe procedure for the emergency treatment of acute complicated diverticulitis. 相似文献
10.
Francisco J. Tinahones Maria Isabel Queipo-Ortuño Mercedes Clemente-Postigo Diego Fernnadez-Garcia Geltrude Mingrone Fernando Cardona 《Surgery for obesity and related diseases》2013,9(2):213-218
BackgroundMorbidly obese patients have associated diseases, such as diabetes, hypertension, hyperlipidemia, and cardiovascular disease. Bariatric surgery improves these obesity-related co-morbidities, including insulin resistance. Evidence has shown that patients with morbid obesity have postprandial hypertriglyceridemia (HTG) and that this type of HTG is related to the degree of insulin resistance. Also, bariatric surgery produces a dramatic reduction in triglyceride levels. However, it is unknown whether patients with postprandial HTG have a different clinical evolution after bariatric surgery. The setting of our study was a university hospital.MethodsWe studied 57 morbidly obese patients who had mild or severe postprandial HTG after fat overload (<30 mg/dL or >90 mg/dL increase in triglycerides, respectively). All the patients underwent bariatric surgery. After surgery, the anthropometric and biochemical variables and the Homeostasis Model Assessment of Insulin Resistance were measured for 1 year at 0, 15, 30, 45, 90, 180, and 365 days after surgery.ResultsThe patients with more severe postprandial HTG had a greater percentage of change in the Homeostasis Model Assessment of Insulin Resistance at 30, 90, and 180 days after surgery than the patients with less severe postprandial HTG. Multiple regression analysis showed that the postprandial triglyceride levels predict the variation in the Homeostasis Model Assessment of Insulin Resistance index, more so than did traditional variables, such as anthropometric, inflammatory, or hormonal data.ConclusionThe postprandial HTG level might be the best predictor of improved insulin resistance in morbidly obese patients after bariatric surgery. 相似文献