Biomedical subjects
Publications and source records attributed to G Padula.
Partial impotence in a twenty-year-old was found, on angiography, to be the result of an arteriovenous fistula of the internal pudendal artery. This condition was corrected by corpus cavernosum revascularization.
A combination of the hook catheter and snare techniques for retrieval of intravascular foreign bodies is described. Using this method, removal time was shortened and the procedure simplified.
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It has been done a manometric intraoperating study on 18 patients (7 acalasical megaoesophagi, 6 herniae of hiatus, 5 duodenal ulcers) who had undergone an operation of modified Dor's anti-reflux plastics. After Haller H.P.Z. pressure has gone down of 13 mmHg, and has gone up again of 5,5 mmHg after modified Dor; after plastics H.P.Z. average intraoperating pressure has been of 18 mmHg. The posterior plastics of hiatus and the reconstruction of His' angle for hernia of hiatus modify scarcely H.P.Z. pressure. During a superselective vagotomy we have recorded a modest reduction of H.P.Z. pressure, of which average intraoperating values after vagotomy and anti-reflux plastics have been of 16,5 mmHg. At a distance of 30 months from the operation it has been done a follow up on 70% of patients that had undergone an operation of anti-reflux plastics and also 18 patients that had had en intraoperating inspection. However it has been, a degradation of manometric values, the results have been satisfactory over 90% of cases. The authors insist on the utility of intraoperating manometry for a valuation of the completenes and the efficacy of the operation.
Sixty-five patients were referred for treatment with symptoms resulting from metastatic cancer to the liver from the GI tract. Two groups of patients were analyzed. The first group of 40 patients were subjected to a laparotomy and insertion of a catheter into the hepatic artery and a second group had the catheter inserted percutaneously and a bolus of cancer chemotherapeutic agents injected into the catheter. In both groups, chemotherapy in the form of 5-fluorouracil was supplemented by internal irradiation delivered from the intraarterial administration of Yttrium 90 microspheres. Forty percent of the patients who had an indwelling catheter performed at celiotomy manifested an objective response and in 60% a significant subjective improvement occurred. In the 25 patients whose catheter was inserted percutaneously, the response rate was roughly similar, in that 35% demonstrated an objective response and 65% demonstrated a subjective response.
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In the absence of a suitable autologous vein for a long distal femoropopliteal bypass, the homologous vein appears to be a good substitute. However, the patency rate after one year is less than 50 per cent and nonanastomotic aneurysms occurred in one third of our patients followed for more than one year. These two complications may be related to an immune response which may be lessened by preservation of the graft in the frozen state. Bovine heterografts function well when placed subfascially for femoropopliteal bypasses ending above the knee. Failure rate is high when the distal end of the graft extends across the knee joint. In our experience nonanastomotic aneurysms have developed in 50 per cent of patent grafts followed for more than one year, although other surgeons have reported an incidence of only 3 to 20 per cent. In the follow-up of twenty-three venous homografts and twenty bovine heterografts placed as femoropopliteal bypasses, eight nonanastomotic aneurysms appeared and required replacement. This occurrence was noted in more than 33 per cent of grafts patent beyond one year. When an adequate autologous vein is not available, the composite Dacron-vein graft is the best substitute.
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