Biomedical subjects

P Mazzoni

Publications and source records attributed to P Mazzoni.

48 records · Page 3Linked to original sources

PubMedDate not supplied

Restorative proctocolectomy or rectum-preserving surgery in patients with familial adenomatous polyposis: results of a prospective study.

Surgical treatment of familial adenomatous polyposis (FAP) is still controversial. From 1984 we carried out a prospective evaluation of total colectomy with ileorectal anastomosis (IRA) and restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) to determine differences in postoperative complications, functional results, occurrence of desmoids, and recurrence of polyps in the rectal stump. IRA was performed below the peritoneal reflection and was indicated in the absence of rectal cancer and in the presence of fewer than 10 polyps or minute polyposis in the last 10 cm of the rectal mucosa. IRA patients underwent a regular endoscopic follow-up and prolonged sulindac administration (100 mg twice daily). When criteria for IRA were absent, IPAA was performed adopting a manual anastomosis at the pectinate line. Fourteen patients were operated with IRA and 24 with IPAA. There was no difference in sex and age between the two groups of patients. The number of rectal polyps was significantly different in the two groups. Immediate postoperative complications were observed in only five IPAA patients, three of whom (12%) required reoperation. Late postoperative complications occurred more frequently in IRA patients (14%) than in IPAA patients (4%). Desmoids developed in both groups (five in the IRA group and four in IPAA group). The number of bowel movements was similar in both groups, but 25% of IPAA patients complained of nocturnal fecal soiling. Fulguration or polypectomy for recurrent polyps was necessary in all but two IRA patients at follow-up. The rectal stump was easily eradicated by polyps in all but four patients with minute polyps at surgery. In the latter patients a diffuse or carpeting rectal polyposis occurred. IPAA can give optimum control of colorectal polyposis in FAP patients with an acceptable incidence of postoperative complications and satisfactory functional results. This type of surgical procedure is indicated in most FAP patients, and IRA should be reserved for patients without polyps or with fewer than 10 polyps in the rectal stump; otherwise growth of polyps cannot be adequately controlled.

Adenomatous Polyposis Coli↗

PubMedDate not supplied

A more biologically plausible learning rule than backpropagation applied to a network model of cortical area 7a.

Area 7a of the posterior parietal cortex of the primate brain is concerned with representing head-centered space by combining information about the retinal location of a visual stimulus and the position of the eyes in the orbits. An artificial neural network was previously trained to perform this coordinate transformation task using the backpropagation learning procedure, and units in its middle layer (the hidden units) developed properties very similar to those of area 7a neurons presumed to code for spatial location (Andersen and Zipser, 1988; Zipser and Andersen, 1988). We developed two neural networks with architecture similar to Zipser and Andersen's model and trained them to perform the same task using a more biologically plausible learning procedure than backpropagation. This procedure is a modification of the Associative Reward-Penalty (AR-P) algorithm (Barto and Anandan, 1985), which adjusts connection strengths using a global reinforcement signal and local synaptic information. Our networks learn to perform the task successfully to any degree of accuracy and almost as quickly as with backpropagation, and the hidden units develop response properties very similar to those of area 7a neurons. In particular, the probability of firing of the hidden units in our networks varies with eye position in a roughly planar fashion, and their visual receptive fields are large and have complex surfaces. The synaptic strengths computed by the AR-P algorithm are equivalent to and interchangeable with those computed by backpropagation. Our networks also perform the correct transformation on pairs of eye and retinal positions never encountered before. All of these findings are unaffected by the interposition of an extra layer of units between the hidden and output layers. These results show that the response properties of the hidden units of a layered network trained to perform coordinate transformations, and their similarity with those of area 7a neurons, are not a specific result of backpropagation training. The fact that they can be obtained by a more biologically plausible learning rule corroborates the validity of this neural network's computational algorithm as a plausible model of how area 7a may perform coordinate transformations.

Algorithms↗

PubMedDate not supplied