Biomedical subjects
Publications and source records attributed to E Tardito.
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This study investigates the histo-pathologic reactions induced by implant of prostheses in Dacron knitted double velour and skin expanders in Silicone elastomers. Particular attention was paid to the effect of these reactions on the tissue itself. In the case of vascular prostheses it was found that fibrous connective tissue tended to accumulate in and around the prosthesis. We also observed widespread lymphohistiocytic infiltration and occasional plasmacytes. Numerous foreign body granulomas were found to be grouped around the filaments of plastic material. The prosthesis itself seemed to be composed of filaments of different calibre, fragmented into particles of varying size. Thus the structure of the prosthesis was modified and discontinued along its whole length. A similar granulomatous inflammatory reaction developed in the case of the skin expander, probably due to the leakage of particles of plastic material through the expander wall, which however did not seem to be affected by the tissue reaction. The findings indicate the need for more detailed research into the material used for prostheses, aimed at determining what modifications the tissues can produce in the synthetic material. Also, it is necessary to follow a multidisciplinary approach which takes into consideration the data available from the chemistry of polymers, fluid mechanics and cell biology.
A personal series of 131 cases of diversion syndrome of the upper and lower extremities is reviewed. 3 cases observed in a study of 100 infants are also reported. Only 12 of the 131 cases are presented as true diversion syndromes and the possible congenital origin is recognised. It is pointed out that the haemodynamic event does not have the significance of a haemometrokinetic phenomenon but of a true diversion capable of activation to the point of attaining the appearance of active localised a-v angiodysplasias.
The problem of "high" proximal insertion at the inferior mesenteric of the synthetic prosthesis in obstructive aorto-iliaco-femoral atherosclerotic pathology is considered. In the light of 3 cases of pseudoaneurysm of the aortic wall, occurring 10, 9 and 7 years after the operation, and hence of problems that presented for the restoration of arterial continuity, distal implantation at the inferior mesenteric is preferred today with a generally end-to-end anastomosis after "cleaning" of the aorta upstream. Disobliteration is therefore avoided. The inferior mesenteric is kept patent if possible by disobliterating it and reimplanting it on the prosthesis, depending of the situation.
Three cases of pure diversion syndrome evolution are reported, by "pure" being meant those characterised by the constant presence of the diversion phenomenon. The increase in the latter may lead these syndromes to be mistaken for active localised a.v.f. pictures. Some notes on treatment are added.
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A case of atherosclerotic aneurysm of the superior mesenteric artery is reported. This was located about 15 cm from its origin and immediately distal to the middle colic artery in a patient who had been operated on 4 years previously with aorto-iliac substitution for aneurysm of the same nature with ligature and section of the inferior mesenteric artery at the origin. Interruption of the latter created further technical problems solved with a serie of anastomoses that permitted the introduction of a good direct flow from the superior mesenteric respectively to the right colic and into an ileal branch which became a bridge or, rather, a "new mesenteric" assuring excellent pulsed flow into the underlying ileal branches, one of which anastomized at the ileocolic. This enabled direct, valid, pulsed flow to be resumed.
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