The authors report on the use of a safety catheter when removing the T-tube in the patients with choledocho-choledochal biliary reconstruction after liver transplantation. After T-tube removal, bile may leak into the peritoneal cavity through the catheter insertion site in the biliary wall. Biliary peritonitis, bilomas, subhepatic collections may develop, which are difficult to treat in immunodepressed patients. The safety catheter is used to allow the external drainage of the biliary outflow, if present, and to prevent the complications due to bile collecting in the peritoneal cavity. Moreover, the catheter allows cholangiography and interventional procedures to be performed when necessary. A soft guidewire is inserted into the distal bile duct through the T-tube and pushed into the duodenum. After removing the T-tube, an 8.3-F all-purpose catheter (APD) is placed on the guidewire with the tip just outside the biliary wall. The APD is then connected to a drainage bag allowing the amount of bile eliminated daily to be checked. This maneuver was performed in 24 transplant recipients and the safety catheter correctly positioned in 22 of them (91.6%). The APD was removed 48 hours after insertion in 15 patients with no biliary leakage. In the remaining 7 patients the catheter was left in situ up to 8 days, since biliary leakage was observed (range: 50-400 ml/day). No early or late complications related to this technique were observed.

Anastomosis, Surgical↗

PubMedDate not supplied

[The complications and outcomes of fractures of the orbital-maxillary-zygomatic complex].

Thirty-three cases of complicated zygomatic-maxillary complex fractures and their complications and sequelae are analysed. Permanent alterations in infraorbital nerve sensitivity (4 cases), amaurosis caused by enucleation of globus (2 cases), diplopia recovered in sixteen cases without treatment and after operation in two cases, ectropion (1 case), subcutaneous emphysema (1 case), scars (3 cases) have been surveyed.

Adult↗

PubMedDate not supplied

[The current therapeutic trends in rhabdomyosarcoma of the cervicofacial area. A review of the topic].

The authors describe the most common clinical characteristics and main parameters of classification of rhabdomyosarcoma in the maxillo-facial area. They draw the most actual therapeutic iter with particular reference to surgical directions, and they examine different prospects of applicability and of prognostic result.

Adult↗

PubMedDate not supplied

[Clinical use of resorbable polymer mini-plates in mandibular fractures: a one-year experience].

The authors describe their experience in rigid fixation of maxillo-facial fractures with resorbable plates made from poly-L-lactic acid. Seven cases are presented, with a one-year follow-up or longer. Plate resorption was evaluated by means of echographic examination, repeated every three months. All fractures healed well, with no complications. Finally, advantages and limits of the material are considered, as well as its future prospects and margins of improvement.

Adolescent↗

PubMedDate not supplied

Effect of G:C-->A:T transition, potentially arising from O6-guanine alkylation, in the transcription regulation of c-fos serum response element.

O6-meGs, if not repaired before cell undergo DNA synthesis, can cause erroneous pairing of thymine resulting in a G:C-->A:T transition, after the next DNA replication. It is known that the presence of O6-meG in promoter sequences inhibits the specific binding of transcription factors. Little is known on the effect of G:C-->A:T transitions on this binding. c-fos SRE was used as a model to study the effect of different G:C-->A:T transitions (at the positions -305, -306, -316, -319 and -320) in terms of SRE specific DNA-binding and functional ability to activate transcription of a reporter gene. The electromobility shift assay and a transient transfection assay were used. The G:C-->A:T transition at -320 caused 92% inhibition, while mutations at the positions -305, -306, -316 and -319 caused respectively 55, 43, 19 and 44% inhibition. The findings indicate that some G:C-->A:T transitions, potentially arising from O6-guanine methylation, can impair the regulation of c-fos transcription.

3T3 Cells↗

PubMedDate not supplied

[Experience with a rigid fixation device in maxillofacial surgery using shape-memory clips].

BACKGROUND: A device of alloy with shape-memorising effect (SME) was utilized in the surgical correction of maxillo-facial fractures. Nitinol, an alloy of equal atomic parts nickel and titanium, is a metal with the unusual property of shape memory. This alloy may be easily bent when cooled in its lower temperature phase and it resumes its original shape when heated in its higher temperature phase. A lot of useful properties of nitinol alloy, such the ability to convert heat energy into mechanical energy, as the biocompatibility and bioinertness, as the anti corrosive stability and high mechanical strength, suggest that it can be useful in the surgical fixation of maxillofacial bone injuries. METHODS: The fixing device of alloy with SME, the indications and the techniques of osteosynthesis and some cases have been discussed by the authors. RESULTS AND CONCLUSIONS: The results of this study showed that the surgical treatment of maxillo-facial bone fractures by devices of shape memory alloys is simple, ensures a good stability of fracture surfaces, reduces the time period of operative procedures and of patients rehabilitation, allowing rapid bone healing.

Adolescent↗

PubMedDate not supplied

Left thoracic approach for cancer of cardia: early and late results.

BACKGROUND: The surgical treatment of cancer of the cardia is controversial and results are often disappointing. Concern exists not only with regards to the surgical approach but also to the extent of the resection. The authors analyze their experience over a 20-year period adopting almost exclusively a "limited" esophagogastrectomy with a wide regional lymphadenectomy through a left thoracotomy. The aim of the study is to determine if this approach actually plays a role in the treatment of this tumor. METHODS: 148 patients were evaluated for cardial cancer. Of these 22 (14.8%) were not resectable and 6 (4%) received other types of resections for technical reasons. 120 patients are the basis of the present analysis. More than 75% of patients were in stage III or IV. Follow-up was completed in 92.5% of cases; all surviving patients had at least 5 years of follow-up. RESULTS: Four (3.3%) patients died in the postoperative period. In 6 cases (5%) an anastomotic leakage occurred and this caused the death of 2 patients. Nine (7.5%) patients had severe pulmonary complications. Dysphagia was relieved in all non complicated patients. 13 (10.8%) patients had anastomotic recurrence. Overall survival rate after 5 years was 25.62 +/- 6.1%. A significant difference in survival was noted in patients at stages II and III after 5 years (61.3% vs 18.6, p < 0.02). CONCLUSIONS: This operation has proved to be a good option providing satisfying long-term results and a lower incidence of complications if compared with more extended procedures. It can be performed in the majority of patients with carcinoma of the cardia with a low mortality and morbidity and with excellent palliation of dysphagia. In our opinion it remains an optimum treatment for cardial cancer.

Adenocarcinoma↗

PubMedDate not supplied

[Lip carcinoma. Various therapeutic options].

Lip carcinoma is a relatively unique malignant disease because the lip is a junctional structure. The lip is bounded externally by the facial skin and it is in continuity with the buccal mucosa of the oral cavity. The lymphatic drainage of the upper and lower lips is primarily directed to the mandibular group of lymph nodes. To a lesser extent, drainage may go to submental intraparotid, or internal jugular lymph nodes. Lip carcinoma is almost exclusively a squamous cell carcinoma, the major etiologic factor being prolonged iar exposure. Treatment for lip carcinoma is usually surgical, in the form of full-tickness excision. Neck dissection is also performed when clinically palpable lymph nodes are present.

Humans↗