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Biomedical subjects

M Fontana

Publications and source records attributed to M Fontana.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

[Chronic idiopathic gastric volvulus in children].

OBJECTIVE: We report clinical, radiograpic and instrumental data about 18 cases of gastric chronic idiopathic volvulus observed since 1997 to june 2000. METHOD: All cases diagnosed by barium meal, performed for vomiting or after a pHmetric esophageal monitoring, in cases of atipical symptoms of gastroesophageal reflux disease. RESULTS: All patients underwent a conservative treatment (antireflux position and procinectics): 5 recovered after 1 year of treatment and 13 were operated on because they did not improve during medical therapy or relapsed after the end of conservative treatment. CONCLUSION: Abnormal position of the stomach is not an absolute indication for surgical treatment. When medical treatment does not obtain improvement in symptoms, surgical option has to be discussed.

Adolescent↗
PubMedDate not supplied

[Small bowel overgrowth: a frequent complication after abdominal surgery in newborns].

BACKGROUND/PURPOSE: Surgery for congenital or acquired gastroenterological disorders, and particularly that associated with short bowel, is not infrequently complicated by Small Bowel Bacterial Over growth (SBBO). Aim of this study is to evaluate the clinical course of children undergoing bowel surgery in the newborn period, assessing the development of SBBO and the response to intensive treatment with a "bowel cocktail" of gentamycin, metronidazole and cholestyramine. METHODS: 17 children with various conditions were studied clinically and by Breath Hydrogen Test (fasting and after glucose). 14 children underwent more than one procedure. All children were treated with overall "bowel cocktail" of gentamycin, metronidazole and cholestyramine. RESULTS: 5 children recovered after one course of treatment and 11 children relapsed at least once and required further courses of therapy. One child died from TPN related liver failure and another following a liver and small bowel transplant for short bowel syndrome. A third child required total intestinal tube splinting according to Sauer and another one required a tapering of the preatretic enlarged jejunal loop. CONCLUSIONS: Our study suggests that children undergoing bowel surgery in the neonatal period and those having more than one procedure are at greater risk of developing small bowel bacterial overgrowth postoperatively. Interestingly, loss of the ileocecal valve was not associated with an increased risk of bacterial overgrowth.

Child↗
PubMedDate not supplied

[Recent trends in the therapy of hepatitis C].

The treatment of HCV correlated hepatitis is an important argument, because of the great incidence and prevalence of this disease. At the end of the Eighties, the IFN was the first substance used for HCV correlated hepatitis therapy. The IFN monotherapy with a dose of 3-6 MU for 6-12 months eradicates the infection in the 15% of cases, and cause an histological temporary improvement in a variable number of patients that keep the infection. In the following years, the research on evaluation of the efficacy of the recombinant interferons or interferons made with genetics engineering (IFN alpha 2a, IFN alpha 2b and IFN Consensus) has given results comparable with the results obtained with IFN alpha. Later, it started the experimentations with IFN associated to other substances, for example IFN-ribavirin combination therapy. The treatment IFN-Ribavirin eradicates the infection in 30% of the patients with the genotype 1b and in 60% with the genotype 2 or 3, while this treatment is less efficacious in the patients with the genotype 4. Recently, it started to use the PEG IFN. The pegylation is the combination of a polietylen-glicole molecule with the IFN molecule, so as to prolong its half-life and reduce the dose only one a week, with reduction of the collateral effects. Some studies has shown that the use of PEG-IFN in monotherapy could help the patients with advanced liver complaint. Successive studies are directed to show the efficacy of the PEG-IFN and ribavirin combination therapy. Recent researches put in evidence new substances, that could represent the future for HCV correlated hepatitis therapy. Between these substances we have to highlight the interleukin, the inhibitors of the viral multiplication and the inhibitors of IMPDH (Inosine monophosphate dehydrogenase). At the beginning of 2002 has made the improvement of HCV vaccine known. Actually, in the USA there are in progress human experimentations, and the production of gamma-globuline, that could be effective to prevent the infection.

Adult↗
PubMedDate not supplied

[Miller Fisher syndrome: review of the literature and presentation of 2 cases].

Miller Fisher Syndrome (MFS), which is characterized by ophthalmoplegia, ataxia and tendon areflexia, is generally considered as a clinical variant of Guillain-Barré Syndrome. However some features of the disease are still debated, particularly regarding possible central nervous system involvement. After presenting two new cases of MFS, the authors provide a critical review of the literature and discuss the nosographical position of the disease. The main conclusions can be summarized as follows: MFS is a predominantly axonal inflammatory neuropathy with prevailing involvement of oculomotor nerves. It is associated to spinal multi or polyneuropathy, which in mildly affected cases is manifested by areflexia, while in severe ones it can be responsible of sense and/or motor impairment. In addition to peripheral neuropathy CNS involvement, exclusive or more marked in posterior fossa, occurs not infrequently. The prognosis of the disease is often benign, but disabling or even fatal outcome is possible. Corticosteroid treatment, possibly because of antiinflammatory and/or immunosuppressive action, could be effective in some patients. Finally, in spite of some similarities with GBS, MFS should be considered as a separate entity with its own nosographical position.

Adult↗
PubMedDate not supplied

Inhibition of human DNA ligase by anthracyclines and distamycins.

Antitumor anthracyclines and distamycins behave as strong inhibitors of human replicative DNA ligase. The enzyme appears sensitive to a specific occupancy of the minor groove of DNA. Inhibition by anthracyclines takes place after enzyme adenylation, does not correlate with DNA unwinding potency but strictly correlates with the presence of an amino group on the sugar. In contrast to the non-toxic distamycin A, its antitumor derivative FCE24517 inhibits DNA joining, enzyme adenylation and AMP-driven DNA topoisomerisation. Our data favour a model in which multiple enzymic targets contribute to the activity of these antitumor drugs.

Antibiotics, Antineoplastic↗
PubMedDate not supplied

[Spontaneous reparation of post-traumatic tympanic perforation: an experimental study in rats].

In most patients tympanic membrane perforation spontaneously repairs itself. Nonetheless, in several cases the perforation persists due either to traumatic or phlogistic damage. Although the membrane perforation healing process has been under study for over a century there are still two contrasting theories. One of these theories asserts that repair takes place through the growth of granulation tissue while the other believes that epithelial migration is at the basis of healing. In the present study an experimental animal model (rat) was used in order to assess the staging of the natural evolution of post-traumatic membrane perforation and to characterize, from a morphological and sub-microscopic point of view, the cellular population and microstructural aspects of the extracellular matrix. Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) were employed to evaluate the progress in tympanic membrane healing and to make a comparison with the most recent theories. Eighteen Sprague-Dawley rats weighing 230-260 gr of the same age (10 weeks) were used in the study. The animals were anesthetized by intraperitoneal injections of Na-pentobarbital (NembutalR) (45 mg/Kg) and, under operating microscope, bilateral perforation of the upper rear quadrant of the pars tensa was performed with a myringotomy lancet. The animals were subjected to periodic follow-ups over next 30 days. Three animals were sacrificed during each control and the tympanic membrane was removed for TEM and SEM study. On the basis of the present study the following conclusions can be drawn: a) primary healing of the lesion is through granulation tissue; b) the healed T.M. is composed of three normal layers as is the normal T.M.; c) the presence of fibroblasts in the intermediate neoformed fibrous layer leads one to conclude that its extracellular matrix is produced and organized "in situ"; d) the neoformed lamina propria has a disorganized, fibrous structure.

Animals↗
PubMedDate not supplied

Influence of diet on cystathionine ketimine and lanthionine ketimine content in human urine.

A simple HPLC procedure for the routine analyses of Cystathionine ketimine (CK) and Lanthionine ketimine (LK) content in human urine has been developed. The values obtained in morning urine of fifteen healthy subjects (both sexes, 25-45 years old) on a common mixed diet are 330-2480 micrograms/g creatinine (mean 1110) of CK and 100-420 micrograms/g creatinine (mean 200) of LK. Quantitation of the two ketimines in urine of subjects on strictly vegetarian diet indicate that while the excretion of LK is independent of the diet, the excretion of CK is significantly decreased in conditions of vegetarian diet.

Adult↗
PubMedDate not supplied

Infantile nontumoral aqueductal stenosis.

A surgical series of 144 infantile triventricular hydrocephalus (from nontumoral aqueductal stenosis) operated on in the period 1957-1982 is presented. The etiological factors, preoperative clinical and anatomical status of the patients are summarized. Their surgical career, the reasons, for revision operations and causes of death are analyzed in relation to each of the four operations performed: ventriculocisternostomies according to Stookey-Scharff or Torkildsen, extrathecal shunts (VA or VP). 46 patients required 72 revision operations, but 23 more patients were lost to follow-up after the first operation. 3 patients (2.0%) died after the first operation, 7 (4.8%) on revision and 18 (12.5%) sometime later. A recent clinical and instrumental review of the physical, neurological and mental status of the remaining 93 patients (64.5% of the total series) has showed that 50 (34.8%) are well or very well; 35 (24.3%) have residual deficits, and 8 (5.4%) are severely handicapped.

Brain Diseases↗
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Bilateral temporal lobectomy for late radionecrosis after radiotherapy for acromegaly. A case report.

A patient with right temporal radionecrosis was submitted to temporal lobectomy for acute intracranial hypertension developed two years after radiotherapy for a GH-secreting pituitary adenoma. Eight months later, a partial left temporal lobectomy was performed because of further radionecrosis. In both instances the cerebral radionecrosis had the clinical and radiological characteristics of a space-occupying lesion. Bilateral temporal lobectomy was followed by a particular psycho-neurological syndrome with bilateral cortical deafness.

Acromegaly↗
PubMedDate not supplied

[Thoracic outlet syndrome. Clinico-instrumental aspects of 36 cases].

The authors report their experience on 36 cases of thoracic tunnel syndrome. They deal with the nosographic arrangement of neurovascular syndromes of the upper limbs. Within the framework of the casuistics 13 patients were operated: the authors present clinical and E.M. Graphic criteria on the ground of which it was decided to operate. Results appear to be positive as to subjective symptomatology; they are less positive as to the objective one.

Angiography↗
PubMedDate not supplied

Acute intracranial hypertension syndrome due to ketamine in a patient with delayed radionecrosis simulating an expansive process.

Reported is the case of a delayed cerebral necrosis in a patient with an eosinophil pituitary adenoma who had undergone radiation therapy. Neuroradiological tests were performed in order to verify the possible existence of a lateral sellar extension of the neoplasm. The administration of ketamine before this examination, presumably caused the onset of an acute temporal syndrome. Surgery was performed without delay, and a delayed cerebral necrosis of the right temporal lobe was found.

Acute Disease↗
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Arthroplasty in the sequelae of congenital hip dysplasia.

The authors report their experience in the surgical treatment of the sequelae of congenital hip dysplasia, more specifically, 125 arthroplasties performed in 116 patients, with specific reference to the technical difficulties encountered and the various surgical methods used. This review suggests that prosthetization yields a high percentage of good results (77%) and constant remission of pain. Nonetheless, joint function, particularly when motion was severely compromised before surgery, or when dislocation was very severe (Crowe grades III and IV), is not always restored.

Aged↗
PubMedDate not supplied

The anchor nail in osteosynthesis of fractures of the humerus.

Osteosynthesis with a humeral anchor nail may be listed along with other methods of intramedullary fixation for the treatment of diaphyseal fractures. The authors report their experience with 33 cases of humeral fractures treated between July 1987 and July 1991. Results were excellent in 61% of the cases, good in 24%, and fair in 15%; no particular complications were reported. The authors believe that the anchor nail constitutes a system of osteosynthesis involving only a small amount of trauma, and allowing for positive elastic stability for the consolidation of the fracture, as well as being a sufficiently safe system so that immobilization in plaster may be avoided. When compared with other systems of intramedullary fixation, the anchor nail is more effective than the Rush nail from a mechanical point of view, and the Kuntscher nail from a biological one.

Adolescent↗