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1.
2.
Fragmentation of methylmethacrylate: a cause of late failure of total hip replacement. A case report
U E Pazzaglia 《Archives of orthopaedic and trauma surgery》1990,109(1):49-52
Extensive localized bone lysis in the femur following implantation of a metal-on-metal total hip prosthesis was observed. Fragmentation of the cement occurred 10 years after implantation. Histologic and ultrastructural features of macrophages are consistent with the hypothesis that particles from the acrylic resin were the factors stimulating the macrophagic reaction. Both mechanical factors and changes of the physico-chemical properties of the cement may have an etiologic role. 相似文献
3.
Distribution of paresthesias in Carpal Tunnel Syndrome reflects the degree of nerve damage at wrist.
Pietro Caliandro Giuseppe La Torre Irene Aprile Costanza Pazzaglia Irene Commodari Pietro Tonali Luca Padua 《Clinical neurophysiology》2006,117(1):228-231
OBJECTIVE: To verify whether the distribution of paresthesias in patients with Carpal Tunnel Syndrome (CTS) is related to the degree of the neurophysiological involvement. METHODS: We performed a cross-sectional study and retrospectively evaluated 163 patients who referred to our electromyography lab and to which a clinical and electrophysiological diagnosis of CTS was made. We divided the patients into two groups: (1) patients complaining of paresthesias at the hand as a whole and (2) patients with paresthesias in the territory of the median nerve. We referred to the distribution of paresthesias at the hand as GLOVE and to the distribution in the territory of the median nerve as MEDIAN. We compared the neurophysiological impairment in GLOVE and MEDIAN distributions. Moreover, we performed multiple regression analysis to evaluate which clinical-neurophysiological variables determined GLOVE and MEDIAN distribution. RESULTS: In our sample, 70.4% of patients had GLOVE distribution and 29.6% of patients MEDIAN distribution. The risk of presenting MEDIAN distribution increases about twice (OR = 2.07; 95% IC: 1.51-2.83) for each unitary increment of neurophysiological class. CONCLUSIONS: The distribution of paresthesias reflects the degree of nerve damage at wrist; patients suffering of SEV/EXT CTS present MEDIAN distribution. SIGNIFICANCE: Our data have important clinical implications because they strongly suggest that we have to consider the possibility of a severe neurophysiological involvement of the median nerve at wrist in patients complaining of MEDIAN distribution. 相似文献
4.
5.
Pierpaolo Sileri Vito Maria Stolfi Giampiero Palmieri Alessandra Mele Alessandro Falchetti Sara Di Carlo Achille Lucio Gaspari 《Journal of gastrointestinal surgery》2007,11(12):1662-1668
Stapled hemorrhoidopexy is widely accepted to treat hemorrhoids, but serious complications have been reported. In this prospective
audit, we correlated clinical outcome with pathological findings. From January 2003 to April 2007, 94 patients underwent hemorrhoidopexy.
Macroscopic appearance of the specimen (shape, size, and depth) was recorded. Microscopically, the presence of columnar, transitional,
and squamous epithelium, the involvement of circular/longitudinal smooth muscle, and features of mucosal prolapse were assessed.
Clinical outcome was evaluated by a validated questionnaire. Postoperative pain, secretion, and bleeding durations were 12.7 +/− 10.6,
5.6 +/− 9.6, and 6.3 +/− 8.4 days. Patient’s return to work averaged 16.7 +/− 10.7 days. Fissure, skin tags, and anal strictures
were observed in 23.4%. Seven patients experienced pain for a significantly longer period of time. All specimens contained
columnar mucosa, but 29.8% contained columnar and transitional epithelium and 12.8% contained columnar, anal transitional,
and stratified squamous epithelium. Smooth muscle was observed in 62.7%. Pain was significantly increased if transitional
epithelium was present in the specimen. No correlation or differences were observed if smooth muscle was present, although
postoperative bleeding was more frequent. Hemorrhoidopexy is safe and effective. The specimen should always be sent for pathology
examination. Only columnar epithelium should be present and, although the presence of smooth muscle does not influence the
outcome in terms of functional results, its presence may play a role in postoperative bleeding.
Presented as poster at the Digestive Disease Week, May 2007, Washington, USA 相似文献
6.
G. Bonaspetti S. Di Fabio R. Fenu L. Costa U. E. Pazzaglia 《Journal of orthopaedics and traumatology》2005,6(1):15-20
Abstract
Polyethylene (PE) wear is a focal issue in joint replacement, so it is essential to understand how it takes place in vivo. PE wear is a multifactorial process with a complex interaction of variables related to the materials used, the mechanical conditions, operative procedures for implantation, activity of the patient and use of prosthesis. We retrieved 65 PE inserts with the respective femoral and tibial components (50 inserts of total knee prostheses and 15 monocompartmental prostheses) from first revision surgeries. The average age of the patients was 68.3 years; the average time to revision was 41.5 months. Macroscopic observation considered the grade, topography and type of wear. Degradation was also studied with scanning electron microscopy. No direct relationship was found between the level of wear and the survival of total or monocompartmental knee prostheses. The duration of 11 (22%) total prosthetic inserts with grade 2 wear was 42.6 months vs. 51.5 months of 17 (34%) total inserts with grade 1 wear. However, study of the relationship between wear grade and wear topography in total inserts suggested that there was a significant connection. In fact, the 22 (44%) prostheses with central and symmetrical wear never showed wear greater than grade 1. Instead, of the remaining 28 prostheses (56%) without central and symmetric wear, only 3 had grade 0 wear. Finally, considering the relationship between wear grade and type of wear, all 18 inserts (27.7%) with grade 2 or 3 wear had 100% delamination. In conclusion, this study suggests that the correct positioning of the prosthetic components, besides its quality, is an important cause of polyethylene wear. 相似文献
7.
T W Freeman J L Clothier P Pazzaglia M D Lesem A C Swann 《The American journal of psychiatry》1992,149(1):108-111
OBJECTIVE: This study was carried out to compare the efficacy of lithium carbonate with that of valproate in acute mania and to determine whether pretreatment clinical characteristics, such as the presence of a mixed affective state, might predict a differential response to the two drugs. METHOD: Twenty-seven patients meeting DSM-III-R criteria for acute manic episodes underwent a 3-week, randomized, double-blind, parallel-groups trial of treatment with lithium carbonate or valproate. Symptom severity was measured by using the Schedule for Affective Disorders and Schizophrenia, change version (SADS-C), the Global Assessment Scale (GAS), and the Brief Psychiatric Rating Scale (BPRS). Drug effects were compared by using repeated measures analysis of variance (ANOVA). RESULTS: At the end of the study, nine of 14 patients treated with valproate and 12 of 13 patients treated with lithium had responded favorably, as measured by changes in the SADS-C mania, BPRS, and GAS scores. Elevated pretreatment SADS-C depression scores were associated with good response to valproate. ANOVA revealed a significant interaction between drug and mixed affective state with respect to treatment response. CONCLUSIONS: Lithium and valproate were both effective in improving manic symptoms, and lithium was slightly more efficacious overall. Unlike the case with lithium, favorable response to valproate was associated with high pretreatment depression scores. Therefore, treatment with valproate alone may be particularly effective in manic patients with mixed affective states. 相似文献
8.
Antonio Giorgio M.D. Luciano Tarantino Giampiero Francica Nicola Mariniello Antonio Nuzzo Luca del Viscovo Antonio Rotondo 《Cardiovascular and interventional radiology》1996,19(1):27-31
Purpose: To verify the efficacy of ultrasound (US)-guided injection of large amounts of ethanol into large or multiple liver lesions,
in a single session under general anesthesia (one-shot PEI) for percutaneous ablation of hepatic tumors.
Methods: Twenty-nine patients (27 with 51 hepatocellular carcinoma (HCC) nodules on cirrhosis, diameter range 1.0<+>–<+>9.0 cm; two
patients with a single metastasis from the gastroenteric tract, 5.0 and 9.0 cm, respectively, in diameter) were treated with
one-shot PEI.
Results: The total volume of alcohol delivered per patient ranged from 16 to 210 ml. Mean ethanol volume in all patients was 49 ml.
Dynamic computed tomography (CT) examination showed complete necrosis in 41 of 50 lesions. Two patients died of hypovolemic
shock due to massive upper gastrointestinal bleeding, 3 and 7 days, respectively, after the interventional procedure. All
the remaining patients are alive (follow-up 5<+>–<+>14 months) except one who died of liver failure 5 months after. New HCC
nodules occurred in six patients within 6 months and one intralesional relapse was recorded.
Conclusion: In this preliminary experience, one-shot PEI is as effective in inducing liver tumor necrosis as traditional PEI; its advantages
are shorter treatment time and the capability of treating larger and multiple liver lesions. 相似文献
9.
CD1a and antitumour immune response 总被引:3,自引:0,他引:3
Primary immune response is based on the capacity of local professional antigen-presenting cells (whose prototype is represented by dendritic cells, DCs) to take up and present antigens to selected clones of T cells, but also to non-specific effector cells such as macrophages or natural killer cells. The four CD1 proteins, all of which share a limited homology to class I MHC proteins, are differently expressed in various cell types, of both mesenchymal and, as recently described, epithelial lineage. Regarding the role of CD1 molecules in the anti-tumour response, it has been reported that CD1+ dendritic cells are involved in the first steps of the primary immune response in a number of malignancies. Moreover, the presence of a high number of DCs in the tumoral or peritumoral area, as well as in the draining lymph nodes, has been shown to correlate with a better prognosis. A recent report on the presence of CD1a in metaplastic epithelial cells of Barrett esophagus introduced new questions about CD1a expression patterns. Moreover, the strong correlation between the lack of CD1a+ cells and the malignant evolution of the lesion may indicate a possible role of non-professional APCs in mediating and/or potentiating immune responses to tumours. 相似文献
10.
A 0.31-kilobase fragment of SV40 DNA containing the early promoter of this virus was isolated. The pX1 plasmid containing the herpesvirus thymidine kinase gene (TK) was cleaved with BglII and SalI to remove the TK promoter. The Sv40 DNA fragment was mixed with the TK gene without its promoter and blunt-end ligated after treatment with S1 nuclease. The newly engineered plasmid was used for the transformation of TK-deficient LtA cells to TK+ phenotype. Blot hybridization experiments show that the plasmid is integrated into high-molecular-weight DNA in both of the transformed colonies that we have studied. Also the mRNA in these cells is a hybrid molecule containing both TK and SV40 sequences. 相似文献