Implantation of a central venous access device.
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Biomedical subjects
Publications and source records attributed to A Bianchi.
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A study was performed in a ten-years period (1980-1990) inside a metallic carpentry department. We carried out noise level measurements: equivalent continuous A-weighted sound pressure level (Leq), personal dosimetry, reverberation time. During the studied period, operation schedule and noise therefore did not change. According our results it appeared a high noisy level (mean Leq 88.3; 89.7) by a fluctuating noise within a building structure with high reverberation time (5 sec.). All employees were young (mean age = 32 years old) and equipped with suitable acoustic protection means: protecting covers with a good lowering of noise level in octave band included between 1 KHz-8 KHz. Audiometry showed a slight worsening among the exposed workers with more seniority and the aged.
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Between November 1986 and June 1987, the microbial aetiology of genital ulcers was assessed in 75 male patients attending the Sexually Transmitted Disease (STD) clinic in Hôpital Saint-Louis, Paris. Evidence of Haemophilus ducreyi was found in 18 patients (24%), Herpes simplex virus in 19 (25.3%). Syphilis was diagnosed on the basis of dark field microscopy and/or positive serology test in 19 patients (25.3%). Lymphogranuloma venereum was not diagnosed in any patient. Primary pathogens were not identified from the remaining 19 (25.3%) men. Neisseria gonorrhoea was isolated in five patients, from the ulcer in three cases, from the urethra in two. Asymptomatic urethral carriage of Chlamydia trachomatis was culture proven in seven cases. The presence of IgM antibodies to C. trachomatis at a titre greater than 40 found in 17 patients was a indication of a current chlamydial infection. Three patients (4%) were discovered to be HIV-1 positive.
Surgery for infants with intestinal atresia has evolved along with the development of specialized neonatal surgical units. This once fatal condition now carries a better than 85% chance of survival and an excellent long-term prognosis. Recent advances in bowel preservation techniques have reduced morbidity and improved gut function in both the long and the short term.
Metabolic and morphological effects of anoxia were studied in alveolar macrophages obtained by lung lavage from guinea-pigs by means of an original method of cell culture allowing direct contact with air without interposition of liquid medium. After selection by glass adherence, alveolar cells were layered on a porous membrane applied to the surface of a reservoir filled with nutrient medium. Alveolar macrophages were then cultured in gas phase under either aerobic or anaerobic conditions for 24, 48 and 72 h. Cellular adenosine triphosphate (ATP) content, an indicator of cell vitality, significantly decreased by 68 and 88% after 48 and 72 h of exposure to anaerobic environment, respectively. Significant increases in lactate production (68% at 24 h) and in glucose uptake (125% at 24 h), evidence of marked glycolytic activity, occurred before these falls in intracellular ATP and parallel decreases in culture medium pyruvate level (76 and 85% at 48 and 72 h, respectively). The shift of energy metabolism resulted in cell death after 72 h, as noted by morphological degeneration and decreased cellular ATP content. Twenty-four hour re-exposure to normoxic atmosphere showed that recovery was possible when duration of anaerobiosis did not exceed 48 h. This reversibility in anoxic cell injury has been related to plasma membrane integrity. The results of these studies indicate that alveolar macrophage resistance to anaerobiosis is limited as ATP content falls and morphological degeneration occurs after 48 h. This novel approach of anaerobic effects at the cell level should be adaptable to investigations of activity and, in particular, the mechanisms of metabolic activity of antianoxic drugs.
Eleven cases of colonic atresia presenting in a 13-year period are described. The incidence of this condition is estimated at 1 per 66,000 live births in the north-west of England. A higher incidence of involvement of the transverse colon has been noted in comparison with previously reported cases. Survival was unaffected by the type of surgical procedure, with both primary anastomosis after resection or staged reconstruction after initial colostomy giving excellent results. No deaths occurred in the ten patients subjected to surgical treatment.
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The aim of this clinical study was to value the antiphlogistic and analgesic efficiency of Nimesulide on 40 patients suffering from facial anomalies and subjected to corrective surgery with many facial osteotomies (Le Fort 1, sagittal osteotomy of mandibular ramus sec. Obwegeser-Dal Pont). Nimesulide was effective in reducing post-surgery oedema and spontaneous and caused pain. Besides it was of easy assumption and well suffered from the major part of the patients subjected to this kind of surgery.
By comparing human embrional gum fragments cultivated in vitro using the technique of Wolff and Haffen with adult gum fragments, the advantages of the fetal gum are evident; and this could serve as a point of departure for an analysis of the differentiation and the cytophysiology of this structure, which is still not very well known.
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In the period between 1981 and 1987, 23 microvascular autotransplantations of intra-abdominal testes were performed on 18 patients at the Royal Manchester Children's Hospital. Nineteen testes [82.6%] were successfully revascularised; however, four [17.4%] became partially or totally atrophic. Early surgery is recommended--well before the age of 2 years, prior to the onset of testicular damage, in order to reduce the risk of infertility. Although the early results are very encouraging, only long-term, postpuberty follow-up regarding both fertility and malignancy can determine the value of testicular autotransplantation.
Between 1980 and 1986, 224 patients underwent one-stage hypospadias repair, of whom 100 were operated on using a modification of the Asopa technique. This technique, in which a vascularised preputial pedicle flap is rotated ventrally in order to reconstruct a neo-urethra as well as to cover the ventral skin defect, is described. The post-operative results are discussed. Fistula formation was the most common complication, but was easily correctable.
A cluster of four Azospirillum brasilense histidine biosynthetic genes, hisA, hisB, hisF and hisH, was identified on a 4.5 kb DNA fragment and its organization studied by complementation analysis of Escherichia coli mutations and nucleotide sequence. The nucleotide sequence of a 1.3 kb fragment that complemented the E. coli hisB mutation was determined and an ORF of 624 nucleotides which can code for a protein of 207 amino acids was identified. A significant base sequence homology with the carboxy-terminal moiety of the E. coli hisB gene (0.53) and the Saccharomyces cerevisiae HIS3 gene (0.44), coding for an imidazole glycerolphosphate dehydratase activity was found. The amino acid sequence and composition, the hydropathic profile and the predicted secondary structures of the yeast, E. coli and A. brasilense proteins were compared. The significance of the data presented is discussed.
Heart rate variability signal in the form of an R-R interval tachogram is detected in Holter type 24-hr ECG recordings. Spectral analysis is carried out over consecutive nonoverlapping records, and the information is displayed in the form of a compressed spectral array through parametric techniques. The trends of spectral parameters such as low-frequency (LF) and high-frequency (HF) powers and central frequencies are also plotted, together with the classical mean R-R value and variance relative to each single spectrum. These parameters quantify the effect of sympatho-vagal balance on heart rate control during the 24-hr period and provide important elements for the diagnostic evaluation of various pathologies, like hypertension. A spectral compression algorithm which checks the position of the poles relative to LF and HF bands inside the unitary circle in the complex zeta-plane is also developed. Applications of this procedure are foreseen in the clinical evaluation of ambulant patients as well as in the study of physical and psychological stress.
Experiments were carried out in mice demonstrating that dietary carotenoids (beta-carotene or canthaxanthin), starting before cancer initiation and continuing throughout the experiment, have a protective effect against indirect skin carcinogenesis induced by benzo[a]pyrene +/- UVA and breast cancer induced by 8-methoxypsoralen + UVA. Experiments in rats demonstrated that carotenoids also prevent the direct gastric carcinogenesis induced by N-methyl-N'-nitro-nitroso-guanidine. Recently, prevention by beta-carotene against colon cancer induced in mice by dimethylhydrazine, another indirect carcinogen, was confirmed by others. The prospects for carotenoid intervention with humans were based on their antitumorigenic effect, which is quite independent of pro-vitamin A activity, their lack of toxicity even after prolonged administration, and their immunostimulating activity. These facts helped to build up a rationale predicting that any epithelial cancer, after radical surgery, can be chemoprevented with supplemental carotenoids. Thus, it is expected that the remaining initiated epithelial tissue will be protected by quenching oxygen radical formation, against the onset of a second primary malignancy. This type of prevention can be envisaged in organs like the lung, urinary bladder, breast, stomach, and colon-rectum. At present, human intervention protocols with a randomized drug/placebo method are underway under the supervision of the Centro Tumori of Pavia to chemoprevent with beta-carotene second primary lung or bladder cancer after radical surgery. Preliminary observations regarding findings in humans without randomization (1980-1988) in Pavia are also reported here. This consisted of chemoprevention with beta-carotene plus canthaxanthin against recurrence of different epithelial malignancies after radical treatment (surgery +/- chemoradiotherapy). None of the 11 cases recruited, on the basis of radical nature of treatment and patient adherence, have shown any recurrence beyond their expected disease-free intervals.