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Biomedical subjects

R Bosco

Publications and source records attributed to R Bosco.

14 recordsLinked to original sources

[Prosthetic rehabilitation with endosseous implants in fibular free flaps reconstructed mandibles].

Mandibular defect following neoplasm resection involves severe alterations in morphology. Today, however, these alterations can be repaired with the use of revascularized free flaps. Chewing can be returned to normal, or at least to an acceptable level, thanks to the insertion of endosseous implants, used both to support the fixed prosthesis and the mobile prosthesis (overdenture). The present work reports the Authors' experience with 5 patients who underwent compound mandibular resection and reconstruction with revascularized fibula free flaps. In all cases the mandible was totally toothless and rehabilitation called for the insertion of a total prosthesis held by a bar secured to the endosseous implant. In 2 cases the implants were inserted at the time of reconstruction. Four patients completed the rehabilitation program, with a 93% (14/15) implant success rate. All were able to return to a normal diet. Likewise the aesthetic results were valid. The main problem was to achieve an adequate interface between the soft tissues and the implants.

Adolescent↗

[Platysma myocutaneous flap in oral cavity reconstruction].

Repairing soft oral tissues which have been removed for oncological reasons is as dauting as it is important. Currently there are many, often sophisticated, methods available but any search for the best possible results must also cause the least patient trauma. The pedicled myocutaneous platysma flap is not new to oral cavity reconstruction although it is not very widespread. We have occasionally used this surgical anatomy, the cases are presented. This flap was performed in 10 cases and proved quite effective; there was no case of total failure as indicated by an orocutaneous fistula. Cutaneous necrosis, partial or total, was seen in 4 cases although it did healed by second intention. The other reconstructive methods are then discussed along with the indications and contraindications as well as some technical insight. One can conclude that the myocutaneous platysma flap is a relatively simple, highly versatile solution although reliability is not the best. The Authors conclude that it is advisable for the surgeon to include the myocutaneous platysma flap as part of his therapeutic arsenal.

Carcinoma, Squamous Cell↗

[Gallstone ileus].

Gallstone ileus is a rare condition whose diagnosis may be difficult. From January 1976 to December 1991 4 cases of gallstone ileus were treated in our hospital, representing 1% of all patients admitted with mechanical bowel obstruction during that period. Three patients were treated by enterolithotomy alone to remove the impacted stone. In one patient intestinal resection of the bowel tract was associated followed by end to end anastomosis. One patient died (33%) seven days after surgery for cardiopulmonary failure. In one patient the obstruction resolved with the passage of a stone per rectum. The Authors conclude that enterolithotomy alone should be the standard procedure for gallstone ileus. The repair of cholecyst-enteric fistula should be done later only if there are continuing or recurrent symptoms.

Aged↗

A sensitive immunochemiluminescence assay for human serum amyloid A protein.

We describe an immunochemiluminescence assay for human plasma serum amyloid A protein (SAA) in which specific rabbit polyclonal antibodies against synthetic peptides are used. The detection of the antigen-antibody reaction at 425 nm is based on a brief emission of light by a luminophor component (signal) in response to chemical energy. The working range of the assay covers plasma SAA concentrations from 5 to 100 micrograms/L. The lower detection limit is 5 micrograms/L, the within- and between-assay CVs are less than 12%. Bilirubin, cholesterol and triglyceride in final concentrations of up to 220 mumol/L, 8.1 mmol/L and 2.68 mmol/L, respectively, do not interfere with the assay. Results were correlated with those obtained by the enzyme-linked immunosorbent assay using the same antibodies (r = 0.95; p less than 0.001; n = 50). This method is inexpensive, simple and easily automated.

Antibodies↗

[The role of skin expansion: giant nevi of the hand].

The Authors, after considering the epidemic and evolution of giant nevi, present their surgical protocol for giant melanocitic nevi of the hand. Their experience is based on 2 cases, but the rarity of these lesions of the hand, the reconstructive technique used and the results obtained justify the report in detail. The Authors used in both cases an expanded groin flap to repair the postexcisional wound. Skin expansion allowed both to obtain flaps, which were wide and reliable, and to close primarily the donor areas. The definitive resorption of the subcutaneous fat caused by the expansion allowed to obtain thin and adaptable flaps, which ensured excellent results also in areas of primary functional value, such as the hand. In both cases, the expanded going flap was used to repair the dorsum of the hand. In one case the lateral and medial parts of the fingers were repaired with skin grafts.

Adolescent↗

[Holter's ECG monitoring in esophagogastroduodenoscopy. Premedication with tiropramide. Preliminary notes].

Endoscopy of the upper digestive tract with flexible instruments is presently a safe, widely used technique in gastrointestinal pathology. Some cases of changes in cardiac rhythm, ventricular fibrillation, ischaemia and cardiac arrest, have, however, been observed during EGDS. The incidence of arrhythmias during EGDS in 41 patients, monitored during the examination with Holter's ECG, has been observed. The results obtained confirm that EGDS does not bring noteworthy cardiovascular changes sufficient to suspend the examination. The absence of parasympathicomimetic effects makes it possible to consider thyropramide one of the drugs of choice in medication before EGDS.

Adult↗