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Biomedical subjects

A Bertani

Publications and source records attributed to A Bertani.

At least 55 records · Page 3Linked to original sources

Skin expansion versus free forearm flap in forehead reconstruction.

The authors present their experience in surgical reconstruction of the forehead cosmetic unit, either with tissue expansion or free tissue transfer. Some of the cases underwent a full reconstruction of the entire cosmetic forehead unit en bloc performed by means of free forearm flap such as in postoncological exeresis and in post-traumatic reconstruction. The other method of choice was tissue expansion. The authors expanded the forehead unit for a giant naevus treatment in a child, and used a bilateral expansion of the forehead for tumour clearance of the middle third of the forehead. Results and problems related to the two techniques are presented and discussed.

Adolescent↗

Transthoracic forequarter amputation and left pneumonectomy.

We describe a variation of the technique of transthoracic forequarter amputation, consisting of a completely anterior approach, removal of the left forequarter en bloc with the chest wall and lung, and sparing of the scapula. This latter bone is mobilized and is used, along with the transposition of the lower ribs, to stabilize the chest wall.

Aged↗

Gigantic epidermoid cyst of the skull.

One case of an unusually giant epidermoid cyst of the skull is described. The neoformation had been present for 40 years, becoming extremely large in the last 20 years, in a 65-year-old woman. Difficulty in wearing glasses was the sole complaint of the patient, who otherwise concealed the mass by wearing a wig. Preoperative examinations (x-rays, CT scan, MRI) were important to better evaluate the nature of the cyst and to make a differential diagnosis. Dissection of the mass from the surrounding tissues was extremely easy because of its capsule. Sixteen months of follow-up have been pleasant, with no evidence of recurrence.

Aged↗

Family history of panic disorder and hypersensitivity to CO2 in patients with panic disorder.

OBJECTIVE: The authors investigated the relationships between hypersensitivity to CO2 and familial-genetic risk for panic disorder in patients with panic disorder. METHOD: Morbidity risks for panic disorder were calculated for families of 203 patients with panic disorder, each of whom was challenged with 35% CO2. RESULTS: Patients who reacted with a positive response to the 35% CO2 challenge showed a genetic risk for panic disorder (morbidity risk = 14.4%) that was significantly higher than that for patients who did not react (morbidity risk = 3.9%). CONCLUSIONS: These findings support the idea that hypersensitivity to CO2 might be associated with a subtype of panic disorder specifically related to a greater familial loading.

Adult↗

35% CO2 challenge in panic and mood disorders.

20 patients with Panic Disorder (PD), 19 patients with Mood Disorder (MD) and 20 healthy controls inhaled one vital capacity of 35% CO2-65% O2 gas mixture and of compressed air in a double-blind, random, cross-over design. Only PD patients showed a strong reaction to 35% CO2 while MD patients and controls did not react significantly. These results support the specificity of the 35% CO2 challenge in PD patients and suggest that PD and MD are separate disorders.

Adult↗

Laboratory response of patients with panic and obsessive-compulsive disorders to 35% CO2 challenges.

OBJECTIVE: The DSM-III-R anxiety disorders section includes both panic disorder and obsessive-compulsive disorder. To evaluate the relationship between these two disorders, subject responses to inhalation of a 35% CO2 and 65% O2 mixture were assessed. METHODS: Twenty-three patients with panic disorder, 23 with obsessive-compulsive disorder, 12 with both obsessive-compulsive and panic disorder, and 23 healthy comparison subjects were given a single vital capacity inhalation of 35% CO2 and 65% O2 or a placebo mixture of compressed air. A double-blind, random, crossover design was used. RESULTS: Patients with panic disorder and patients with both panic disorder and obsessive-compulsive disorder showed similar strong anxiogenic reactions to 35% CO2; while patients with obsessive-compulsive disorder alone did not differ from comparison subjects. CONCLUSIONS: These results confirm that obsessive-compulsive disorder and panic disorder are two distinct syndromes and that patients with these disorders have different sensitivity to CO2 inhalation.

Administration, Inhalation↗

Sensitivity to 35% CO2 in healthy first-degree relatives of patients with panic disorder.

OBJECTIVE: The authors tested the hypothesis that hyperreactivity to CO2 in healthy subjects represents an underlying familial vulnerability to panic disorder. METHOD: One vital-capacity inhalation of 35% CO2 and 65% O2 was administered to each of 84 patients with panic disorder, 23 healthy first-degree relatives of probands with panic disorder, and 44 healthy subjects with no family history of panic disorder. RESULTS: The first-degree relatives of the probands with panic disorder reacted significantly more than the healthy subjects and significantly less than the probands. CONCLUSIONS: These findings suggest an association between family history of panic disorder and hyperreactivity to 35% CO2 in healthy subjects.

Administration, Inhalation↗

Subclinical impairment of lung airways in patients with panic disorder.

Lung function was assessed in 17 panic patients and 20 healthy controls. Panic patients had abnormal values for some dynamic lung volumes, namely Peak Expiratory Flow Rate (PEFR), Expiratory Flow at 75% of Vital Capacity (FEF75) and Maximum Mid-Expiratory Flow Rate (MMEF). Such functional abnormalities might indicate subclinical obstruction of lung airways, possibly relevant to the mechanisms related to panic disorder (PD).

Adult↗

Plasma interleukin-1 beta concentrations in panic disorder.

Plasma interleukin-1 beta (IL-1 beta) concentrations were measured in 10 outpatients with panic disorder before and on days 30 and 32 of treatment with alprazolam (2-2.5 mg/day). IL-1 beta concentrations were found to be significantly higher in patients than in control subjects both before and during therapy. Thus, IL-1 beta levels may be a marker of panic disorder that is not related to the current level of symptomatology.

Adult↗

Carbon dioxide/oxygen challenge test in panic disorder.

The effects of a single inhalation of a 35% CO2/65% O2 gas mixture were examined in 71 patients with panic disorder with or without agoraphobia and 44 normal control subjects. Compared with the placebo condition, inhalation of air, the CO2/O2 mixture elicited a clear anxiety reaction only in panic disorder patients, who experienced a sudden rise of subjective anxiety as well as of several panic symptoms. Respiratory symptoms and the fear of dying best distinguished the patients from the control subjects. Baseline anxiety was not the key factor in explaining this differential reaction. The clinical features of panic disorder (namely, frequency of panic attacks, agoraphobia, anticipatory anxiety, and duration of illness) were not significantly related to the response to the challenge test, suggesting that CO2 reactivity might be a trait marker of panic disorder.

Administration, Inhalation↗

The use of acellular autologous skeletal muscle grafts in peripheral nerve repair: a morphometrical-morphological study.

Alternative materials for autologous nerve grafts in peripheral nerve surgery have long been investigated. This report describes the use of acellular (freeze-thawed) autologous skeletal muscle grafts (ASMG) to bridge a 2 cm gap in the sciatic nerve of rats. Neurophysiologic and morphometric studies performed 6 weeks after surgical procedure showed for the nine treated Sprague-Dawley rats (Group A) a good axon regeneration rate, although this was lower than that for the control group (Group B), a lower Nerve Conduction Velocity (NCV) and a thinner myelin sheath than in group B (n = 9 Sprague-Dawley rats). In the latter case, complete resection of 2 cm of the sciatic nerve was followed by an immediate coaptation of the proximal and distal ends.

Animals↗

Pharmacologic effect of toloxatone on reactivity to the 35% carbon dioxide challenge: a single-blind, random, placebo-controlled study.

The effect of a short treatment (7 days) with the reversible monoamine oxidase type A inhibitor toloxatone on the reactivity to the inhalation of 35% CO2 was evaluated in 18 panic patients who responded to 35% CO2 inhalation with panic before treatment. A single-blind, placebo-controlled design was applied. Panic patients were randomly assigned to the toloxatone (N = 10) or placebo (N = 8) groups and were given the 35% CO2 challenge on days 1 (before starting the treatment), 3, and 7. Patients on placebo did not report any significant changes in their reactivity to 35% CO2 during the three sessions, whereas patients on toloxatone reported a significant attenuation of the reactivity on day 7. These results indicate that (1) anxiety provoked by the inhalation of 35% CO2 is reproducible; (2) placebo has a negligible effect on 35% CO2 reactivity; and (3) reactivity to 35% CO2 is significantly attenuated by short treatment with toloxatone, possibly related to its antipanic activity.

Administration, Inhalation↗

[Regeneration of peripheral nerves after interposition of acellular muscle into larger defects].

Peripheral nerve grafting is an established procedure in reconstructive surgery. Nerve grafts, however, are only available to a limited extent and patients are faced with neurologic deficits at the donor areas. Pretreated skeletal muscle has been proposed as an alternative grafting material. In nine adult Sprague-Dawley rats, a 2 cm gap of the sciatic nerve is grafted with a M. gracilis segment which has been pretreated through repeated freezing and thawing. Regeneration is evaluated after six weeks postoperatively. The results are compared to nine conventional nerve grafts. Regeneration was evident in all grafts. Histologically, the muscle grafts revealed a high proportion of connective tissue, a good vascularisation but an inferior degree of myelinisation. Morphometrically, the muscle grafts proved to be inferior according to axon counts and myelinisation. Muscle grafts provide a substrate comparable to peripheral nerves regarding the tubular architecture based on laminin. There are however no viable Schwann cells within these substitutes, which makes them inferior compared to conventional nerve grafts for peripheral nerve repair. These results are discussed with respect to further experiments concerning allogeneic nerve grafting and peripheral nerve preservation.

Animals↗

Paget's disease of the vulva: advantages of demolitive surgery.

Four patients with vulvar Paget's disease were analysed retrospectively. In all cases the clinical manifestation was typical, with pruritus and visible lesion. None of the cases had a palpable cutaneous or subcutaneous mass but at the histologic exam a minimally invasive Paget's disease was detected. Treatment consisted of total vulvectomy and subsequent new reconstructive time; only one patient with clinically localized disease was treated with simple vulvectomy. Postoperative complications were minimal, thanks to the reconstructive time that assured a rapid recovery of the surgical injury and reconstruction of the urethral and vaginal meatuses. In all cases we obtained the complete removal of the lesion (negativity of resection margins), except in one case that was also the only one to have a recurrence after 40 months. The patients have been followed for an average of 58 months. Considering the results, we suggest demolitive surgery with subsequent reconstructive time in the treatment of vulvar Paget's disease.

Aged↗

Wound management with N-carboxybutyl chitosan.

In patients undergoing plastic surgery, donor sites were treated with soft pads of freeze-dried N-carboxybutyl chitosan to promote ordered tissue regeneration. Compared to control donor sites, better histoarchitectural order, better vascularization and the absence of inflammatory cells were observed at the dermal level, whilst fewer aspects of proliferation of the malpighian layer were reported at the epidermal level. Accordingly, N-carboxybutyl chitosan leads to formation of regularly organized cutaneous tissue and reduces anomalous healing.

Adult↗

Morphological study of the capsular organization around tissue expanders coated with N-carboxybutyl chitosan.

Expanders coated with N-carboxybutyl chitosan were inserted into surgical wounds in the dorsal skin of rabbits and the formation of capsular tissue was studied by scanning electron microscopy and transmission electron microscopy. N-carboxybutyl chitosan, in the course of the capsular organization, favours and potentiates the correct proliferation and organization of the tissue, rather than sustaining reactive processes leading to scar formation. N-carboxybutyl chitosan stimulates physiologically the tissue repair process and favours angiogenesis, whilst depressing fibrogenesis to a certain extent. Applications are envisaged in the treatment of wounds and in plastic surgery.

Animals↗

Vulval reconstruction after cancer excision: the island groin flap technique.

Many current techniques for vulval reconstruction following cancer excision satisfy the basic requirements for restoration of urinary and sexual function but leave considerable scars on the thigh. We suggest the use of bilateral island groin flaps, which allow a good cosmetic and functional reconstruction with a minimal donor defect and more acceptable scars. This technique also allows good access to the inguinal, crural and iliac lymph nodes through the same incisions, avoiding other scars.

Female↗