[Complications of reconstructive vascular surgery. Intra-abdominal pseudoaneurysm and vasculo-enteric fistula].
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Biomedical subjects
Publications and source records attributed to R Scorza.
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One to ten year follow-up of 90 patients with post-phlebitis syndromes in various stages is reported. Stress is laid on the fact that treatment of the post-phlebitic limb has not yet been clearly defined, and that various medical and surgical measures are adopted from one case to another. A personal preference for surgical management, restricted to the superficial circulation and the "projected" interruption of incompetent communicating vessels, is expressed, though if considerable trophic lesions are present their regression by means of medical treatment only is regarded as an essential prerequisite to surgery. "Restricted" surgical management gave results that were more than satisfactory in 72.7% of cases, as in other series in the literature.
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Authors analyze some results obtained treating, with selective arterial perfusion (using antienzymes), experimental acute pancreatitis in dogs (fifteen). The first dogs' group was used to perform several experimental acute pancreatitis; the second group was treated by selective arterial perfusion and was related to group of dogs treated by i.v. antienzymes drugs. Histological and biochemical data are discussed. The results obtained with arterial perfusion are preliminary referred as better than classic i.v. antienzymes drugs therapy.
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In human one-way mixed lymphocyte reactions we have observed an increase in the percentage of sIgD bearing lymphocytes, detected by direct membrane immunofluorescent staining. This increase does not seem to be attributable either to the synthesis of sIgD receptor molecules by previously negative T or null cells or to a non specific stimulation of B cells by a factor released in the course of the MLR.
The Authors analyse 121 cases of patients affected by abdominal malignant tumors, who underwent a palliative operation. Although the number of the examinated cases is small, it appears clear that the longest survival requires, when possible, the removal of most of the malignant tissue. This seems to be in accordance with the results reported by the literature.
A case of arterial hypertension due to suprarenal medulla hyperplasia is reported. Having accepted the existence of this form, the problem of its recognition is stressed, in the presence of catecholamine pathology, even though the type or site of its anatomo-pathological substrate cannot be identified, explorative surgery and possible removal of the suprarenal glands can be indicated.
Authors analyze a personal series of patients surgically treated for renal artery diseases (177 cases). Criteria of screening and diagnosis of stenosis are discussed and also are referred the clinical data. Authors describe their own personal reconstructive technique on renal arteries. Early and late results are widely analyzed.
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Twenty-one cases of gastro-enteric complications during aorto-iliac-femoral reconstructive surgery carried out from 1965 to 1973 in the Department of Surgery of University in Milan are studied. Causes, frequence, clinical data and medical and surgical procedures are discussed.
First, lymphocyte transplantation into total body-irradiated rats is discussed. The effect on spleen colony formation caused by the transplantation of untreated lymphocytes, as well as of lymphocytes previously incubated with PHA, or with PHA plus L-asparaginase, or with lymphokines, was studied. Then the effect of the urinary colony-stimulating factor in vitro, and the in vitro feeder-layer activity of leucocytes on colony formation of human and mice bone marrow cells in haematological diseases is dealth with. The injection of rat lymphocytes previously incubated for 24 hours with PHA resulted in a higher number and a larger size of colonies in the spleen of the recipient rats. Lymphocytes preincubated with lymphokines gave rise to the formation of spleen colonies which were larger than those developing after the injection of untreated lymphocytes. When the lymphocytes were previously incubated with PHA plus L-asparaginase, PHA failed to stimulate colony formation in the spleen. The phenomenon is explained by assuming that PHA, as an aspecific stimulator of cell division, initiated the division of CFUs, thus the CFUs content of the preincubated samples increased, resulting in an increase in the number of colonies formed after the transplantation of lymphocytes pretreated with PHA. Another possible explanation is that CFUs division, or their spleen take is enhanced by the immunocompetent lymphocytes activated by PHA, either directly or via soluble mediators produced or released by immunocompetent lymphocytes such as lymphokines. The study of colony-forming cells and colony-stimulating activity in primary myelofibrosis (PM) showed an increase in the number of circulating CFUc in this condition, and an abnormal density of these cells reaching a peak below 1.062. The lowering of CSA in the first two peripheral blood gradient fractions agrees with the observation in the same fractions of a high percentage of CFUc at the expense of the CSC population. Thus, double cell population seems to exist in PM. One is greatly abnormal with a low specific density and high plating efficiency, whereas the other population is almost normal, showing a higher specific density and a lower plating efficiency.
The authors compare the figures for a sequence of lumbar ganglionectomy operations in 2 different time spans. They point to a reduction in lumbar ganglionectomy indications as related to the spreading of arterial reconstructive surgery. The follow-up review of the results has shown that th percent worsening rate in the second time span should be ascribed to a change in the kind of cases rather than to a modification in the nature of indications. The authors conclude by describing the role of lumbar ganglionectomy as fundamental in dysfunctional, inflammatory and peripheral degenerative forms, and supporting in reconstructive surgery operations on mixed atherosclerotic forms.
It was previously reported that PHA-incubation of a pool of peripheral-blood lymphocytes before their i.v. injection into rats submitted to total body irradiation, stimulates spleen colony formation and growth. On the same model, the present study has investigated the effect of lymphocyte preincubation with supernates obtained in short term cultures from human lymphocytes prestimulated with PHA (lymphokines). The "in vitro" culture of rat lymphocytes in a medium supplemented with human lymphokines showed either a marked increase of lymphocyte survival rate, or significant stimulation of lymphocyte blastogenesis, but at an extent much lower than that caused by PHA, also because in this particular experiment the culture medium was supplemented with too little amount of lymphokines. These data support the interpretation that human lymphokines may act across the species barriers. Peripheral-blood rat lymphocytes prestimulated with human lymphokines, and then injected i.v. into rats previously submitted to total body irradiation, caused significant increase in the spleen weight, as well as formation of spleen colonies quite larger and with higher erythroid differentiation - though less numerous than in the controls (i.e., in the rats injected just with untreated lymphocytes). This behaviour may be due to the tendency to merge together of two or more colonies in a single giant colony, and supports the interpretation that immune-competent lymphocytes activated either with PHA or with lymphokines may stimulate spleen colony growth and erythroid differentiation, though at different extents.
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