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Biomedical subjects

V Lepore

Publications and source records attributed to V Lepore.

At least 55 records · Page 3Linked to original sources
PubMed1988

Reduction of post-thoracotomy pain by cryotherapy of intercostal nerves.

In a prospective study, 144 patients undergoing thoracotomy were randomized to two groups: In 71 cases cryoanalgesia was applied intraoperatively to the intercostal nerves above and below the incision to relieve postoperative pain, and 73 (control group) received bupivacaine-adrenaline intercostal blockade at the end of the operation. The amount of administered narcotic and mild analgesics, the visual analogue pain scores, the need for further intercostal blockade and the number of postoperative bronchoscopies to clear retained secretion were significantly less in the cryoanalgesia group than in the controls. There were no late nerve complications after cryoanalgesia, which is recommended for routine use in thoracotomy.

Analgesia↗
PubMed1987

Inadvertent transarterial pacemaker insertion: an unusual complication.

We describe an unusual complication of pacemaker treatment in a patient who died after a replacement operation. In a difficult situation in which a functioning pacemaker was highly desirable and in which most of the available veins had already been used, the pacemaker electrode was inserted, by mistake, through a small artery. This was not detected by fluoroscopy during surgery. The postoperative X-ray examination seemed to indicate that the electrode tip was located in the coronary sinus, but the subsequent autopsy revealed it to be located in the left ventricle.

Aged↗
PubMed1987

Surgical management of tracheal tumours.

The annual incidence of primary tracheal tumours in Sweden is less than 1 per million population. Five cases of malignant tracheal neoplasm treated with segmental resection and primary reconstruction are described. Exploration and mobilization of the trachea were performed via right thoracotomy. Suprahyoid laryngeal release was also done in two cases, using a cervicomediastinal approach. The length of resected segment in these cases was 6 and 7 cm. High-frequency positive-pressure ventilation was used in four of the five cases and greatly facilitated the operation. Recovery was uneventful. Adenoid cystic carcinoma was too extensive for extirpation in one case, but 4 months after radiotherapy a 7 cm tracheal segment with residual tumour was removed; 3 years later the patient is well. There was no stenosis or other late complication and no local recurrence in the long-term survivors. No vocal paralysis occurred. The two patients with laryngeal release had remarkably little and transitory dysphagia. Technical problems are discussed and conclusions are presented.

Adult↗
PubMed1985

Dopaminomimetic action of diphenylhydantoin in rat striatum: effect on homovanillic acid and cyclic AMP levels.

Diphenylhydantoin (DPH) is known to induce reversible paroxysmal dyskinesias and paranoid psychosis in humans, but its interactions with dopamine (DA) metabolism are not clear. Single doses of DPH (60-100 mg kg-1), with serum levels over 10 micrograms ml-1, reduced homovanillic acid (HVA) levels in rat striatum. The DPH-induced HVA decrease was enhanced by supersensitivity of postsynaptic DA receptors following chronic haloperidol (Hal) administration. DPH 60 mg kg-1 given acutely enhanced the HVA decrease induced by apomorphine (Apo) and partially counteracted the HVA increase following acute Hal (0.1-0.5-2 mg kg-1). After chronic DPH treatment, Apo was ineffective in reducing striatal HVA levels. Concomitant chronic treatment with DPH and Hal counteracted the development of supersensitivity of postsynaptic DA receptors to Apo. Single doses of DPH (30-60-100 mg kg-1) increased cyclic AMP striatal content; this effect was blocked by Hal. A dopaminomimetic DPH action and a subsensitivity of postsynaptic DA receptors after chronic DPH seem to be suggested. These effects could be related to the dyskinetic and psychotic syndromes produced by the drug.

Animals↗
PubMed1980

Isoelectric focusing and quantitative estimation of cerebrospinal fluid and serum IgG in idiopathic polyneuropathy.

Isoelectric focusing and quantitative estimation of serum and CSF IgG were performed in 85 patients with idiopathic polyneuropathy (IP), subdivided according to the clinical course (acute, subacute, recurrent, chronic). Acute IP very frequently had an increase of oligoclonal and/or polyclonal serum IgG during the progressive phase and blood-CSF barrier damage accompanied by polyclonal IgG intrathecal synthesis during the stationary phase. Polyclonal IgG intrathecal synthesis was also present in several not acute IP and seemed to forecast unfavorable course. Oligoclonal IgG synthesis occurs very rarely within CSF but is a frequent finding in serum of patients with IP. Abnormalities of the IgG serum pattern are neither specific for any clinical course of IP nor of prognostic value. The possible significance of such findings is discussed.

Adolescent↗
PubMedDate not supplied

Treatment of descending thoracic aneurysms by endovascular stent grafting.

PURPOSE: Endovascular stent-graft treatment for true aneurysms of the descending thoracic aorta is a valid and effective alternative to conventional surgery. A review of our experience with 21 consecutive patients is reported and technical considerations are discussed. METHODS: Twenty-one patients (mean age 73 years) with true aneurysms of the descending thoracic aorta (n = 14) or contained rupture (n = 7) were treated between October 1999 and July 2001. Seven patients (33%) underwent emergency endovascular procedure. Postoperatively, the patients were followed with CT scans at 1, 3, 6, and 12 months. Follow-up, which averaged 17 months, was 100% complete. THIRTY-DAY RESULTS: No conversions to open repair were necessary. Two patients died (10%), one of acute intestinal ischemia and the other because of multiorgan failure. Four patients showed endoleaks immediately after stenting. Two patients required new endovascular stentgrafts, while the remaining two were treated conservatively. Besides endoleaks, eight major complications occurred in six patients (two stroke, two paraplegia, two respiratory insufficiency, and one renal failure). MID-TERM RESULTS: Three more patients died during the follow-up period. One patient died of heart failure after a complicated postoperative course, 91 days after stenting. The second patient died because of aortic rupture, 139 days after stenting. The third patient died of heart failure, 15 months after the endovascular procedure. The remaining 16 patients are alive and have been regularly controlled by CT scans. No late migration or endoleaks have been detected. In all the survivors, the size of the aneurysm was unchanged or diminished. CONCLUSIONS: Treatment of descending thoracic aortic aneurysms by endovascular stentgraft devices has good early and mid-term results. More accurate selection of patients may further reduce mortality and morbidity.

Aged↗
PubMedDate not supplied

The influence of electroencephalographic focus laterality on efficacy of carbamazepine in complex partial and secondarily generalized tonic-clonic seizures.

Forty-five outpatients with chronic epilepsy with complex partial seizures (CPS) alone or associated with secondarily generalized tonic-clonic seizures (SGTCS) were treated with carbamazepine (CBZ) monotherapy. All patients had only a unilateral scalp electroencephalographic (EEG) focus. Left- (n = 29) and right- (n = 16) sided foci patients were comparable for age, sex, duration, and etiology of epilepsy as well as total and free CBZ serum levels. CBZ significantly improved CPS irrespective of the side of the EEG focus, whereas SGTCS were controlled for greater than 1 year in 15 of 19 patients with left focus and in three of 11 patients with right focus. When patients with poorly controlled seizures discontinued CBZ and changed to other therapies, they achieved a significant reduction in number of SGTCS, whereas the number of CPS was unchanged. The side of EEG focus seemed to be relevant to the control of SGTCS by CBZ. Interhemispheric neurotransmitter asymmetries may be involved in the EEG focus side-dependent CBZ response.

Adult↗
PubMedDate not supplied

[A case of strangulated trans-omentum hernia].

After a review of the Literature, the Authors report a case of intestinal obstruction caused by trans-omentum hernia. This unusual disease is due to a defect of the greater omentum with herniation and secondary strangulation of small bowel. The clinical presentation was that of an intestinal obstruction with rare possibility of preoperative diagnosis. Therefore, a correct knowledge of this pathology and immediate surgery are necessary for the prognosis.

Aged↗
PubMedDate not supplied

[Biologically borderline neoplasms: epithelial hemangioendothelioma. A case report].

The case of a patient affected by an epithelial hemangioendothelioma of the arm is described. A definitive diagnosis was possible only by histologic examination. The difficulty to reliably predict the biological behaviour of these tumors is emphasized and therefore the necessity of a follow-up of the patient for many years is stressed, even in the case of a histologically benign tumor.

Adult↗
PubMedDate not supplied

[Chorea in hemodialysis: Is chorea just a neurological syndrome or is it related to uremia or dialysis?].

Chronic renal failure and haemodialysis patients are prone to develop encephalopathy. The causes of encephalopathy are often unclear. Clinical signs of encephalopathy in the uraemic patient often overlap with several other affections causing neurological disorders. Whenever basal ganglia are anatomically involved, movement disorders arise, including chorea. Some acute and chronic neurological syndromes associated with chronic uraemia have consistently been reported (uraemic encephalopathy, dialysis disequilibrium syndrome, dialysis dementia, nephroangiosclerosis neuropathy and ageing neuropathy). Other clinical conditions in which neurological involvement exists are not so frequent in both haemodialysis patients and in the general population (Wernicke's encefalopathy, Creutzfeldt-Jacob disease). Because of the non specific symptoms and the very heterogeneous aetiology, a careful physical examination should be performed in haemodialysis patients with clinical signs of encephalopathy and the main metabolic alterations should be sought; moreover, central nervous system imaging examination is often appropriate. In case of basal ganglia anatomical involvement, supported by findings of imaging techniques, it is necessary to evaluate individual causes of encephalopathy by means of more accurate tests including analysis of cerebro-spinal fluid, measurement of plasma levels of vitamin B components and laboratory tests searching for more uncommon diseases such as Huntington's chorea and Wilson's disease.

Aged↗
PubMedDate not supplied

Replacement of the oesophagus with a segment of colon experience of 30 cases and technical considerations.

Thirty consecutive patients who underwent oesophageal replacement with a segment of colon (16 for malignant and 14 for benign disease) were reviewed. The operation was done in one stage in 28 cases and in two stages in two. The interposed colon was always placed isoperistaltically, in the bed of the oesophagus in 24 and retrosternally in 6 cases. In seven patients a valve was constructed to prevent gastrocolic reflux. There was one early postoperative death (3%). Early non-fatal complications occurred in 5 (17%), and late complications in 6 patients (20%). The functional results were excellent to good in 21 (73%), acceptable in 7 (24%), and poor in 1 (3%). The data suggest that colonic interposition offers a good alternative to stomach in selected cases with oesophageal malignancy and represents an excellent choice for reconstruction in benign oesophageal disease.

Colon↗
PubMedDate not supplied

Cervical radiculopathy following botulinum toxin therapy for cervical dystonia.

The development of transient right-sided lower cervical root impairment is reported in a 49-year-old woman affected by cervical dystonia, who had previously received botulinum toxin injections into the left sternocleidomastoid and the right trapezius. The possibility of a causal relationship was discussed with consideration of: 1) the absence of intercurrent illness or trauma; 2) the positive correlation between sensory-motor disturbances and the botulinum toxin-induced remission of cervical dystonia; 3) the reversibility of cervical radiculopathy (there was no recurrence in the two years following the interruption of the treatment). Magnetic resonance imaging investigation disclosed an abnormal cervical spine geometry together with moderate spondylosis. We feel that mechanical postural changes following the successful botulinum toxin treatment for cervical dystonia might have played some role in the development of cervical radiculopathy. Thus, skeletal abnormalities should be checked when attempting to correct muscle overactivity by botulinum toxin.

Botulinum Toxins↗
PubMedDate not supplied

[Inguinal hernia repair in the elderly: modified Shouldice procedure, 10 years of experience].

Authors relate their experience of 10 years period (1984-1994) with Shouldice technique for inguinal hernia repair in the elderly. This technique, in the Author's clinical practice, replaced the Bassini operation. The personal series is costituted of 190 patients underwent to inguinal repair during a 10 years period from 1984 to 1994 with recurrence rate of 1.1% (2 pt.). Authors consider Shouldice operation to be most valid from the methods of direct suture, with lower recurrence range.

Aged↗