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Biomedical subjects

T Clerici

Publications and source records attributed to T Clerici.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Educational opportunities in minimally invasive surgery].

Since minimally invasive surgery makes high demands on the skill, concentration and endurance of the surgeon, requisite training in this operating technique is of overriding importance. Basic training on pelvitrainers serves to enable the participant to become acquainted with the instruments and the video technique and to gain experience in handling the camera. A realistic simulation of intraoperative situations is not possible. With pulsatile organ perfusion (POP) nearly all abdominal, thoracic, vascular, urological and gynecological surgical procedures, as well as the encountered complications, can be imitated, widely replacing the need for animal experiments. Complex operations which are bound to anatomical structures, have to be practised on anaesthetized animals, as before.

Animals↗
PubMed1994

[Can one dispense with preoperative cholangiography in connection with laparoscopic cholecystectomy?].

Since the introduction of laparoscopic cholecystectomy as method of choice for the treatment of gallstone disease, many authors have proposed a preoperative intravenous cholangiogram as an alternative to routine intraoperative cholangiography. To assess the value of intravenous cholangiography we performed a prospective randomized study with 100 patients undergoing cholecystectomy for gallstone disease. Patients with predefined criteria indicating possible choledocholithiasis were excluded. In none of the 50 performed i.v.-cholangiograms was evidence of a stone in the common bile duct or an anatomic variation of the biliary tract found. There was no significant difference in regard to intra- and postoperative complications between the group with preoperative cholangiography and the group without intravenous cholangiogram. We conclude that there is no significant advantage in performing routine preoperative intravenous cholangiography, and recommend the selective use of intraoperative cholangiography.

Cholangiography↗
PubMed1994

[Therapy of choice in complicated diverticulitis?].

Between 1988 and 1992 we treated in our hospital 79 patients with a complicated diverticular disease. We analysed and compared two groups (group A 42 cases January 1988 to February 1991/retrospectively, group B 37 cases March 1991 to December 1992/prospectively). We studied our operative procedure in respect to the postoperative morbidity and lethality, the number of performed and persistent stomata and the mean length of stay. The complications of diverticular disease in both groups were similar. Since March 1991 we performed primary resection with primary anastomosis in 89% of the patients, three-stage resection or primary resection with an anastomosis and a proximal colostomy was no more done. The Hartmann procedure was rarely chosen (only in 4 of 37 patients). In spite of forcing the primary resection with a primary anastomosis in group B, the complication rate (local and general) decreased from 35.7% to 29.7%, the lethality rate from 9.5% to 2.7%. The number of performed stomata showed a great difference with 22 in group A against 4 in group B. The mean length of stay was 31 versus 22 days. Therefore we consider primary resection with an anastomosis for the best therapy in complicated diverticular disease.

Aged↗
PubMed1992

[Incidence of recurrence in long-term follow-up of 100 patients after surgery for primary hyperparathyroidism].

The percentages for recurrence or persistence of hyperparathyroidism after operation for pHPT vary between 3 and 7% according to the pertinent literature. These groups of authors have a broad experience based on a large number of patients treated. At our institute we have operated for pHPT an average of 5 patients per year. Given our limited experience we reexamined 100 consecutive patients which were operated for pHPT between 1968 and 1988 in order to determine our own rate of recurrence. The rate for persistent or recurrent hyperparathyroidism was at 8% slightly higher than in the literature reviewed. When reexamining the patients we took the history concerning the preoperative symptomatology and its postoperative course. Furthermore we compared a radioimmunoassay measuring the midmolecule region of the parathyroid hormone with a immunochemiluminometric assay determining the intact and biologically active hormone regarding sensitivity and specificity. The results are presented and compared with the literature reviewed.

Aged↗
PubMed1991

[Results of in situ bypass].

The "in situ" bypass technique was adopted by our group in 1986. A total of 53 "in situ" bypasses were carried out until June 1989. The worst symptoms were incapacitating claudication, rest pain or ischemic necrosis, each in about one third of the patients. The site of the distal anastomosis was the popliteal artery below the knee in 40 instances, the peroneal artery in 7 and other infrapopliteal vessels in 6. Valve incisions were performed uneventfully with reusable instruments featuring a sharp-edged blade and an indicator for rotation control of the blade ("Insitutom RC"). Vein branches were located mostly by angiography, but residual arteriovenous fistula remained a vexing problem. In the beginning they were ligated under local anaesthesia. Later on they were dealt with successfully using transluminal embolization. Patients were last examined in July 1990 when the follow-up time ranged from 12 to 51 months. 4 patients had died and 5 were lost to follow-up. Patency rates were evaluated according to the life-table method. They were gratifying for femoro-popliteal bypasses with 87 percent after one year and 83 percent after two and three years. Femoro-tibial-peroneal bypasses performed below average, but their number was too small to draw conclusions.

Adult↗
PubMed1991

[Mid-term results of our first 53 "in situ" bypasses].

The "in situ" bypass technique was adopted by our group in 1986. A total of 53 "in situ" bypasses were carried out until June 1989. The worst symptoms were incapacitating claudication, rest pain or ischemic necrosis, each in about one third of the patients. The site of the distal anastomosis was the popliteal artery below the knee in 40 instances, the peroneal artery in 7 and other infrapopliteal vessels in 6. Valve incisions were performed uneventfully with re-usable instruments featuring a sharp-edged blade and an indicator for rotation control of the blade ("Insitutom RG"). Vein branches were located mostly by angiography, but residual arterio-venous fistula remained a vexing problem. In the beginning they were ligated under local anaesthesia. Later on they were dealt with successfully using transluminal embolization. Patients were last examined in July 1990 when the follow-up time ranged from 12 to 51 months. 5 patients had died and 5 were lost to follow-up. Patency rates were evaluated according to the life-table method. They were gratifying for femoro-popliteal bypasses with 87% after one year and 83% after two and three years. Femoro-tibial-peroneal bypasses performed below average, but their number was too small to draw conclusions.

Adult↗
PubMed1989

Penile melanosis.

Five patients with penile melanosis are described. The lesions consisted of macular hyperpigmentation of the penile shaft and/or glans. Histologically only hyperpigmentation of the basal cell layer was observed with no melanocytic hyperplasia. Patients had follow-up for 3 to 13 years; enlargement of some lesions was observed, but the condition remained benign. The main differential diagnostic problem was with acral lentiginous melanoma. Penile melanosis shares clinical and microscopic features with Laugier-Hunziker syndrome of the buccal mucosa and vulvovaginal melanosis. We suggest that the three disorders be grouped as essential melanotic hyperpigmentation of mucosa.

Adolescent↗
PubMed1985

[Angiolymphoid hyperplasia with eosinophilia. Optical and histo-immunological study of 5 cases with an electron microscopy study of one of the cases].

5 cases of angiolymphoid hyperplasia with eosinophilia of the skin are reported. This rare condition was initially described in 1969 by Wells and Whimster. The microscopical pattern is characterised by an atypical vascular proliferation associated with an eosinophilic and lymphoplasmocytic granuloma. In our series, immunohistological study demonstrated the polyclonality of the plasmacytoid component. Electron microscopy performed in one case shows endothelial features even in cells forming clusters without well-defined lumen. These results support the endothelial origin of angiolymphoid hyperplasia with eosinophilia.

Adult↗
PubMed1983

[Buschke's scleredema and monoclonal dysglobulinemia: apropos of 3 cases].

A monoclonal gammopathy was observed in 3 adult patients with long-term and widespread scleredema (Buschke's disease). There was no evidence of multiple myeloma in any patient. The monoclonal immunoglobulin was in every case of the IgG-kappa type. Bence Jones proteinuria was noted in 1 case (kappa). Deposition of monoclonal IgG-kappa in the skin was not detected by immunofluorescence microscopy. These findings and previous reports of 5 cases suggest that diffuse scleredema may be frequently associated with paraproteinemia, but the role of monoclonal immunoglobulins in the pathogenesis of the disease remains to be clarified.

Adolescent↗
PubMedDate not supplied

[Multinucleate cells angiohistiocytoma].

INTRODUCTION: Multinucleate cell angiohistiocytoma is a rare entity. We report two unusual cases of this lesion. CASE REPORT: A 39 year-old man had presented since two years an arciform papular eruption of the forehead. A 40 year-old woman had a disseminated maculo-papular eruption since three years. Histological examination of skin samples of the two patients showed a dermal small vessel proliferation, associated with multinucleate cells, and confirmed the diagnosis of multinucleate cell angiohistiocytoma. DISCUSSION: Our cases, typical histologically, have unusual clinical presentation (first case observed in a man, and the second in a disseminated form). Multinucleate cell angiohistiocytoma is a rare benign vascular proliferation individualized in 1985. Clinically, the lesion consists in small circumscribed papules. Acral sites and notably of the dorsum of the hands are the more frequent topography. It generally occurs in women aged over 50 years. Histologically, there is a dermal proliferation of capillaries and venules, and a fibrosis associated with the interstitial mononucleate cells and multinucleate cells.

Adult↗