Percutaneous Radiologic Gastrostomy: A 12-Year Series

( Franco Perona ),( Giorgio Castellazzi ),( Alessandro De Iuliis ),( Laura Rizzo ) 대한소화기기능성질환·운동학회 2010 Gut and Liver Vol.4 No.s1

Background/Aims: Interventional radiologists have played a main role in the technical evolution of gastrostomy, from the first surgical/endoscopical approaches to percutaneous interventional procedures. This study evaluated the results obtained in a 12-year series. Methods: During the period December 1996 to December 2008, 254 new consecutive gastrostomies and 275 replacement procedures were performed in selected patients. All of the cases were treated by a T-fastener gastropexy and tube placement. The procedures were assessed by analyzing indications, patient selection, duration of the procedures, and mortality. Results: All 254 first gastrostomies were successful; replacement procedures were also successfully performed. One (0.2%) patient with severe neurologic disorders died after the procedure without signs of procedure-related complications, and seven (1.3%) major complications occurred (four duodenal lesions with peritoneal leakage, two gastric bleedings, and one gastric lesion). Minor complications were easily managed; three tube ruptures were resolved. Conclusions: This long-term series and follow- up showed that a group of interventional radiologist can effectively provide gastrostomy placement and long-term tube management. Percutaneous gastrostomy is less invasive than other approaches and it satisfies the needs even of high-risk patients. (Gut Liver 2010;4(Suppl. 1):S44-49)

The role of softening in the numerical analysis of R.C. framed structures

Bontempi, Franco,Malerba, Pier Giorgio Techno-Press 1997 Structural Engineering and Mechanics, An Int'l Jou Vol.5 No.6

Reinforced Concrete beams with tension and compression softening material constitutive laws are studied. Energy-based and non-local regularisation techniques are presented and applied to a R.C. element. The element characteristics (sectional tangent stiffness matrix, element tangent stiffness matrix restoring forces) are directly derived from their symbolic expressions through numerical integration. In this way the same spatial grid allows us to obtain a non-local strain estimate and also to sample the contributions to the element stiffness matrix. Three examples show the spurious behaviors due to the strain localization and the stabilization effects given by the regularisation techniques, both in the case of tension and compression softening. The possibility to overestimate the ultimate load level when the non-local strain measure is applied to a non softening material is shown.

Survival implication of lymphadenectomy in patients surgically treated for apparent early-stage uterine serous carcinoma

Jvan Casarin,Giorgio Bogani,Elisa Piovano,Francesca Falcone,Federico Ferrari,Franco Odicino,Andrea Puppo,Ferdinando Bonfiglio,Nicoletta Donadello,Ciro Pinelli,Antonio Simone Laganà,Antonino Ditto,Mari 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.5

Objective: Uterine serous carcinoma (USC) is a rare highly aggressive disease. In the presentstudy, we aimed to investigate the survival implication of the systematic lymphadenectomy inpatients who underwent surgery for apparent early-stage USC. Methods: Consecutive patients with apparent early-stage USC surgically treated at sixItalian referral cancer centers were analyzed. A comparison was made between patients whounderwent retroperitoneal staging including at least pelvic lymphadenectomy “LND” vs. those who underwent hysterectomy alone “NO-LND”. Baseline, surgical and oncologicaloutcomes were analyzed. Kaplan- Meier curves were calculated for disease-free survival(DFS) and disease-specific survival (DSS). Associations were evaluated with Cox proportionalhazard regression and summarized using hazard ratio (HR). Results: One hundred forty patients were analyzed, 106 LND and 34 NO-LND. NO-LNDgroup (compared to LND group) included older patients (median age, 73 vs.67 years) andwith higher comorbidities (median Charlson Comorbidity Index, 6 vs. 5) (p<0.001). Nodifferences in terms of recurrence rate (LND vs. NO-LND, 33.1% vs. 41.4%; p=0.240) wereobserved. At Cox regression analysis lymphadenectomy did not significantly influenceDFS (HR=0.59; 95% confidence interval [CI]=0.32–1.08; p=0.09), and DSS (HR=0.14; 95%CI=0.02–1.21; multivariable analysis p=0.07). Positive node was independently associatedwith worse DFS (HR=6.22; 95% CI=3.08–12.60; p<0.001) and DSS (HR=5.51; 95% CI=2.31–13.10; p<0.001), while adjuvant chemotherapy was associated with improved DFS (HR=0.38;95% CI=0.17–0.86; p=0.02) and age was independently associated with worse DSS (HR=1.07;95% CI=1.02–1.13; p<0.001). Conclusions: Although lymphadenectomy did not show survival benefits in patients whounderwent surgery for apparent early-stage USC, the presence of lymph node metastasis was the main adverse prognostic factors, supporting the prognostic role of the retroperitonealstaging also in this histological subtype.

Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D

Sara Pieropan,Franco Antoniazzi,Elisa Tadiotto,Federico Caldonazzi,Maddalena Maschio,Giulia Aiello,Giulia Melotti,Paolo Cavarzere,Giorgio Piacentini 대한골대사학회 2019 대한골대사학회지 Vol.26 No.4

Background: Bone marrow oedema (BMO) in children/adolescents is a rare clinical condition without an etiologic cause. It is associated with typical increased signal intensity on T2-weighted magnetic resonance images (MRI) and an increase in bone turnover in which vitamin D plays a pivotal role. No treatment guidelines for these young patients are to date available. Methods: We performed a retrospective study in a pediatric setting of 13 patients with diagnosis of primary BMO of the foot on the basis of clinical and radiological findings. Data collection included sex, age, patient history, symptoms at presentation, clinical examination, laboratory bone turnover markers, vitamin D levels, MRI, treatment, and outcome. Results: Vitamin D deficiency or insufficiency was found in 76.9% of cases. All patients were treated with adequate vitamin D daily intake, a short course of analgesic therapy, physical therapy, avoiding detrimental feet and ankle immobilization. All fully recovered in 3-month lag period. Conclusions: Our data highlight that environmental factors, such as underestimated articular or bone microtraumatisms, as well as joint hyper mobility, in a bone turnover milieu of vitamin D deficiency could be the cause of this clinical conditions. Adequate vitamin D supplementation, associated with physical and analgesic therapy, is crucial in the management of BMO.

Stress path adapting Strut-and-Tie models in cracked and uncracked R.C. elements

Biondini, Fabio,Bontempi, Franco,Malerba, Pier Giorgio Techno-Press 2001 Structural Engineering and Mechanics, An Int'l Jou Vol.12 No.6

In this paper, a general method for the automatic search for Strut-and-Tie (S&T) models representative of possible resistant mechanisms in reinforced concrete elements is proposed. The representativeness criterion here adopted is inspired to the principle of minimum strain energy and requires the consistency of the model with a reference stress field. In particular, a highly indeterminate pin-jointed framework of a given layout is generated within the assigned geometry of the concrete element and an optimum truss is found by the minimisation of a suitable objective function. Such a function allows us to search the optimum truss according to a reference stress field deduced through a F.E.A. and assumed as representative of the given continuum. The theoretical principles and the mathematical formulation of the method are firstly explained; the search for a S&T model suitable for the design of a deep beam shows the method capability in handling the reference stress path. Finally, since the analysis may consider the structure as linear-elastic or cracked and non-linear in both the component materials, it is shown how the proposed procedure allows us to verify the possibilities of activation of the design model, oriented to the serviceability condition and deduced in the linear elastic field, by following the evolution of the resistant mechanisms in the cracked non-linear field up to the structural failure.

Complex open elbow fracture-dislocation with severe proximal ulna bone loss: a case report of massive osteochondral allograft surgical treatment

Chiara Concina,Marina Crucil,Emmanouil Theodorakis,Giorgio Saggin,Silvia Perin,Franco Gherlinzoni 대한견주관절의학회 2021 대한견주관절의학회지 Vol.24 No.3

We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, if needed.

Vitamin D and Male Fertility: An Updated Review

Gianmartin Cito,Andrea Cocci,Elisabetta Micelli,Alejandro Gabutti,Giorgio Ivan Russo,Maria Elisabetta Coccia,Giorgio Franco,Sergio Serni,Marco Carini,Alessandro Natali 대한남성과학회 2020 The World Journal of Men's Health Vol.38 No.2

To date, the key role of vitamin D in male reproductive system has been suggested, since the expression of vitamin D receptors and metabolizing enzymes was demonstrated in the testis and spermatozoa. Nevertheless, a general consensus about the role of vitamin D in male fertility is still debated. The aim of this review is to provide an updated systematic revision of the current available literature, discussing the experimental and clinical evidence on the role of vitamin D in the regulation of testis hormone production, seminal parameters and male fertility. The consequences of vitamin D deficiency on serum levels of testicular hormones have been analysed by several observational and interventional studies, with controversial results. Equally, the experimental researches not were able to state a certain relationship between vitamin D status and testis hormone production. Possible bias, including age, body mass index, and baseline vitamin D status justified the differences among studies. As well as concerning the effect of vitamin D on semen parameters, most of the studies agreed in the possibility that vitamin D might have a positive effect on human male fertility potential, particularly through better sperm motility. Regarding pregnancy outcomes, normal level of vitamin D seems to be related to better pregnancies. However, all the previous studies displayed a wide heterogeneity in study design, population, methodology, and cut off values used for the evaluation of vitamin D status. Future studies are needed to better clarify the exact role of vitamin D on hormonal and seminal panel in both fertile and infertile men.