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Biomedical subjects

A Caroli

Publications and source records attributed to A Caroli.

At least 37 records · Page 2Linked to original sources

Single nucleotide polymorphisms (SNPs) within Bov-A2 SINE in the second intron of bovine and buffalo k-casein (CSN3) gene.

The genetic polymorphism of an entire Bov-A2 element located in the second intron of the buffalo and bovine k-casein (CSN3) gene was investigated by amplification and sequencing of PCR products. Single nucleotide polymorphisms were detected. A PCR-RFLP method was developed to detect an A or G mutation at position 605 of bovine Bov-A2 element which creates a BfaI polymorphic site. The frequencies of the B allele, with the BfaI site, were for 0.275, 0.775, 0.750, 0.975, respectively, for Italian Holstein Friesian, Grey Alpine, Friuli Red Pied and Reggio bovine breeds. The mutation rate (substitutions and deletions/insertions per nucleotide site per year) was 2.5 x 10(-9) for Bov-A2 sequences in the second intron of CSN3. The comparison with other Bov-A2 elements suggests that this retroelement might be an important source of single nucleotide polymorphism for analysis of Bovidae genomes.

Animals↗

Divergent dislocation of the fourth and fifth carpometacarpal joints.

A case of divergent dislocation of the fourth and fifth carpometacarpal joints is reported. The injury resulted from a high-energy trauma and was treated by closed reduction and cast immobilization for 4 weeks. Evaluation at the 26-month follow-up visit showed good radiographic and functional results.

Casts, Surgical↗

[MRI in the postoperative assessment of pseudoarthrosis of the scaphoid bone treated by corticocancellous bone graft. Report of 31 cases].

Thirty one scaphoid pseudarthroses treated by corticocancellous bone graft between November 1985 and December 1988 were reviewed with a mean follow-up of 33.9 months. Clinical examination assessed pain, wrist mobility, and strength of grip. Radiological assessment evaluated consolidation of the corticocancellous graft, the presence or absence of graft resorption and the possible presence of radiocarpal osteoarthritis. A discordance between clinical and radiographic results was observed. Six patients had an excellent or good clinical result, but a poor radiological result and one patient with a poor clinical result presented an excellent radiological result. We therefore decided to use MRI to more clearly define the cause of this discordance and to verify the viability of the graft.

Adolescent↗

Replantation of degloved skin of the hand.

The treatment of a degloving injury is one of the most difficult problems in hand surgery. Various reconstructive procedures have been adopted in the past years, all with poor results. Between 1988 and 1995, nine patients with degloving injuries of the hand and fingers were treated by microsurgical replantation. The injury involved the thumb in three patients, the ring finger in three patients, the little finger in one patient, and multiple fingers in two patients. Successful complete revascularization was obtained in seven patients. In one case a superficial necrosis of the replanted thumb skin occurred with good preservation of the subcutaneous layer. In one patient with a degloving injury involving multiple fingers, revascularization was achieved only in the middle finger, and the first ray was secondarily resurfaced by a free flap from the foot. In our experience revascularization of the degloved skin does represent the best solution and must be managed as an emergency procedure. Coverage obtained in this way offers the best cosmetic result and allows early mobilization with good recovery of joint movement. Reestablishing sensibility is more difficult. It is not always possible to suture the nerves damaged by the trauma, and even when a careful primary nerve anastomosis is performed, the results often are unsatisfactory, probably because of the avulsive mechanism of nerve injury.

Adult↗

Cell behavior and cell-matrix interactions of human palmar aponeurotic cells in vitro.

The present investigation has been performed to better characterize, in vitro, normal aponeurotic cells in comparison with dermal fibroblasts and with cells derived from Dupuytren's affected aponeuroses. Cells were cultured in monolayer and/or into three-dimensional collagen gels. Cell structure, adhesion, and spreading capability on different substrates, as well as integrin expression were investigated by light and electron microscopy and by flow cytometry. Cell-matrix interactions were also analyzed by gel retraction experiments in the presence, or absence, of RGD peptides and anti-integrin antibodies. Normal aponeurotic cells, compared with dermal fibroblasts, exhibited in vitro peculiar structural features, which were substantially maintained in Dupuytren's aponeurotic cells, irrespective of the substrate they were grown on. By contrast, the aponeurotic cell behavior was different in normal and diseased cells, these latter approaching that of dermal fibroblasts. Normal aponeurotic cells, in fact, were characterized by low efficiency in retracting the collagen gel, low alpha 2, alpha 1, and alpha 5 integrin subunit expression and low adhesion properties onto collagen and fibronectin, whereas cells isolated from the aponeuroses of Dupuytren's patients exhibited higher capability of retracting the collagen gel, increased adhesion properties toward collagen and fibronectin, and higher levels of integrin expression. No differences were observed between dermal fibroblasts from Dupuytren's patients or from normal subjects. These in vitro results are consistent with those previously obtained in situ, suggesting that palmar aponeurotic cells have a peculiar phenotype and that changes in cell-matrix interactions occur in Dupuytren's contracture. Moreover, by comparing data obtained from the retracted fibrotic cords and the still clinically unaffected aponeuroses of the same patients, it may be noted that Dupuytren's disease is not only confined to the clinically involved branches, but includes the whole aponeurosis of the affected hand.

Cell Adhesion↗

Microsurgical approach for a venous malformation of the thumb.

We report a case of a low-flow venous malformation of the thumb treated by microsurgical excision of the mass and a free toe pulp flap. Forty-two months after surgery the patient had a good cosmetic and functional results without any recurrence of the tumour.

Adult↗

[An experimental study of a cyanoacrylate biological adhesive in view of its use in the fixation of various fractures of the fingers].

Following certain interesting results reported in publications by researchers from the nineteen-sixties up to the present time, we decided to experiment a particular adhesive with high adhesive properties: this is composed of monomers of alpha-cyanoacrylate éthyl-2-alpha-cyanoacrylate. For this end, experiments were performed on 15 adult chickens, aged around 4 months, weighing 2 kg, divided into 5 groups of 3 chickens each. In each chicken, a rectangular bone fragment from the proximal-middle third of the tibia was prepared, completely separated, and then subsequently re-positioned and fixed with the adhesive plus collagen. At pre-established intervals (7, 14, 21, 30 and 60 days), each group of chickens was examined by x-rays and then killed, so that the particular anatomical part under examination could be studied both microscopically and macroscopically. The aim of these experiments was to evaluate the ability of cyanoacrylate adhesive to ensure setting of small bone-fragments that would otherwise be unstable. The results obtained showed the following: good stability of the bone fragment; good bone consolidation; absence of foreign body reactions. The positive nature of these results leads us to propose the use of this adhesive in hand surgery. Nevertheless, duty requires that further experiments be performed in order to acquire even greater guarantees for the positive results obtained.

Animals↗

Homodigital neurovascular island flaps with "direct flow" vascularization.

Pulp loss of the fingers is frequently observed. When local advancement flaps are not sufficient to repair the defect, the homodigital monopedicled island flaps with "direct flow" are a simple and current reconstructive solution. Between 1991 and 1995, 32 homodigital neurovascular direct flow island flaps were performed for fingertip defects. We used a modified triangular Venkataswami flap for oblique amputations (26 patients) and the Mouchet-Gilbert island flap for tangential defects (6 patients). Our results (with excellent skin quality and good sensory recovery) lead us to consider these flaps as the first-choice reconstructive solution in patients with extensive but not complete pulp defects (< 2 cm) of the fingers.

Adult↗

Ring avulsion injuries: microsurgical management.

Microsurgical treatment of ring avulsion injuries is often difficult, due to widespread intimal damage of the digital vascular bundles. Thirty-one patients with such injuries in varying degrees were treated during the period 1986 to 1992: of these, 15 underwent microsurgical revascularization. In addition to the traditional procedures applied in seven patients (arteriolysis, direct vessel suture, vein grafts), a technique consisting of vessel transfer from the middle finger was also employed. In five patients, the ulnar digital artery of the middle finger was transferred to the ring finger. In four patients, at least one vein was transferred from the dorsal aspect of the middle finger. Twelve of 15 microreconstructions were successful: with an average follow-up of 48.3 months, these patients showed very good functional (mean total active range of motion: 234 degrees and mean s2PD: 9.8mm) and cosmetic recovery. These results lead to the conclusion that, except for cases characterized by proximal amputation at the flexor superficialis tendon insertion, microsurgical treatment should always be carried out.

Adult↗

Prognostic value of some laboratory parameters in a group of intravenous drug users in the early stages of HIV infection.

During a 5 year follow-up we found significantly reduced survival for non-accidental deaths in 37 intravenous drug users (IVUDs) in the early stages of HIV infection when compared with 32 HIV-negative IVUDs (p = 0.017). Moreover, in HIV-positive subjects, survival was significantly reduced for those groups which at the beginning of the follow-up showed the following values: circulating CD4+ lymphocytes <250/mmc (p = 0.007), CD4+/CD8+ ratio < 0.5 (p = 0.027), serum albumin < 4.13 g/dl (p = 0.045), IgA > or = 2.5 g/l (p = 0.043), IgM < 1.8 g/L (p = 0.041) and platelet count < 130 x 1,000/mmc (p = 0.038). In HIV positive patients, the value of 250 units/mmc for the circulating CD4+ lymphocytes still remained the most predictive parameter of increased mortality for disease at 5 years, even following investigations conducted with other cut-offs. Relationships existing at the beginning of the follow-up between circulating CD4+ lymphocytes and other prognostic parameters suggest that IgA (r = -0.34; p = 0.04), serum albumin (r = 0.33; p = 0.05), and CD4+/CD8+ ratio (r = 0.72; p = 0.0001), but not IgM (r = 0.25; N.S.) and platelets (r = 0.07; N.S.), are dependent variables of shortened survival.

CD4 Lymphocyte Count↗

Osteosarcoma of the scaphoid. A case report and review of the literature.

We describe a case of osteosarcoma of the scaphoid bone, which to our knowledge is only the second reported case of osteosarcoma in the carpus. A 38-year-old man complained of intense pain in the right wrist and had curettage and a bone graft for a lesion in the scaphoid. Histological examination showed this to be an osteosarcoma. Below-elbow amputation was performed and adjuvant chemotherapy given. There has been no evidence of recurrence or metastases at 33 months after amputation.

Adult↗

First web space reconstruction by a free flap from the contralateral paralysed hand.

In modern reconstructive surgery any composite tissue removed during an elective ablative operation may serve as a vascularised free-tissue transfer for a possible distant reconstruction. The use of this technique does not create a donor deficit and may help in the reconstruction process. We report a case in which the dorsum of a paralysed and insensate right hand has been used as a free tissue transfer for the reconstruction of the first web space of the left hand.

Adult↗

Acute posterior interosseous nerve palsy caused by a synovial haemangioma of the elbow joint.

A case is described of spontaneous posterior interosseous nerve palsy of acute onset. The initial symptoms made it difficult to distinguish the condition from tendon rupture. The diagnosis was established using ultrasound, nerve conduction studies and MRI. The patient underwent surgery to decompress the posterior interosseous nerve and the histological examination identified the tumour as a synovial haemangioma. 12 months after the operation, the patient had made a complete recovery, confirmed by EMG.

Acute Disease↗

[A reverse vascular autograft finger island flap. A review of 15 cases and of the literature].

The authors discuss the indications for homodigital island flap with a reverse vascular pedicle. This flap is based on the anastomoses between the radial and ulnar digital arteries. These anastomotic branches lie between the posterior wall of the tendon sheath and the periosteum to form an arch and are named the "digitopalmar arches". The vascularization of the reverse homodigital island flap is derived by using the middle transverse palmar arch. This flap was performed successfully in 14 patients involving 15 fingers to resurface amputation of the distal phalanx. In 6 cases the flap was used as an "artery" flap, and in 9 cases as a "sensitive" homodigital island flap. The pedicle in these cases was neurovascular also containing the digital nerve. The sensitivity of the flap was obtained by neurorraphy between the transposed digital nerve of the flap and the receiving digital nerve of the recipient finger. This technique achieves cover of the tactile pad in one operative stage and provides well vascularized skin allowing early mobilization. Sensation of the flap can be restored rapidly when neurorraphy of the transposed digital nerve is performed.

Adolescent↗