[Results and complications of axillo-femoral by-pass].
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Biomedical subjects
Publications and source records attributed to F Gabrielli.
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Histones were prepared and purified from chick embryo, chick and chicken liver nuclei. The comparative analysis of these histone preparations, fractionated by polyacrylamide gel electrophoresis, indicates that histone fractions of chick embryo, chick and chicken livers are respectively identical and they comigrate with calf thymus histones.
The A. report their own experience about 226 cases of by-pass and 46 cases of T.E.A. for aorto-iliac disease performed by the Department of Surgical Semeiotics in the University of Trieste. The results of 116 direct bilateral implants and of 23 monolateral implants are discussed. Intraoperatory mortality was about 8%. Early complications occurred in 9, 4%: thrombosis and prosthesis infections (5 cases) were the most important accidents. Late complications were thrombosis (19 cases), infection (1 case) and 2 A-E fistulas. It is possible to obviate late thrombosis with early reoperations. Long-term follow-up (106 patients) shows good results in 70, 8%, while thrombosis of the by-pass occurred in 17, 9%; 12 patients showed a distal ischemia of the limbs and required complementary reoperations. On the basis of their experience the A. stress that the results of aorto-femoral by-pass should be considered quite satisfactory.
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The authors consider 74 patients who have undergone reoperation for recurrent peptic ulceration in their hospital, between 1971 and 1980. Recurrences followed gastrectomy (39 cases), vagotomy (33 cases) and gastroenteroanastomosis (GEA) (2 cases). The reoperations were: vagotomy or revagotomy; gastric resection or reresection; vagotomy combined with resection. Assessment of results was based on Visick clinical grading: 24 patients remained in Visick grade III and IV. Failure was due to a second recurrence in nine patients, who therefore underwent further operations, but two patients remained in Visick grade III and there was one operative death. The authors conclude that most patients end with both a vagotomy and a gastric resection and that the final postoperative results remain fairly poor in some cases. In attempting to cure recurrent ulcers most surgeons stress that reoperation is the treatment of choice, but all the surgical procedures are potentially difficult and therefore potentially dangerous. Nowadays, the results of medical management (cimetidine) seem satisfactory, but we must still fully evaluate the side-effects of the long-term maintenance treatment.
Authors stress that multiple carcinomas of the large bowel are not exceptional at all and report 5 cases of metachronous cancers and 1 case of synchronous cancers. They are 4,4% of all the colo-rectal neoplasms operated by the "Istituto di Semeiotica Chirurgica dell'Università di Trieste". The Authors discuss the most important pathogenetic, pathological and diagnostic problems and emphasize the usefulness of a very careful intra-operative evaluation of the entire colon and of a post-operative follow-up for the early discovery and treatment of a second cancer in another tract of the large bowel.
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