Cleft Palate Repair: A New Maxillary Nerve Block Approach.

Objective: To introduce a different approach for maxillary nerve block (MNB), in cleft palate repair. To reduce the use of opioids during surgery and to prevent frequent respiratory complications by means of an adequate intra and postoperative pain relief.

Patients And Methods: A prospective clinical trial was planned, to collect scientific evidences between 2 groups of patients with primary cleft palate, receiving surgery in 2 Pediatric centers of Buenos Aires, utilizing a different protocol.

Van der Woude and Popliteal Pterygium Syndromes.

: Van der Woude syndrome is the most generic form of syndromic orofacial cleft, present in approximately 2% of all cleft patients. The lower lip pits with or without cleft lip and/or palate is typical of this syndrome. Popliteal pterygium syndrome (PPS), also known as popliteal web syndrome or fasciogenito-popliteal syndrome, was first described by Trelat in 1869, the incidence is approximately 1 in 300,000 live births.

Photochemical investigation of a photochromic diarylethene compound that can be used as a wide range actinometer.

The photochromic diarylethene derivative 1,2-bis(5-(4-ethynylphenyl)-2-methylthiophen-3-yl)perfluorocyclopentene (1) was submitted to photochemical, thermal stability and fatigue resistance studies in acetonitrile, also to evaluate its possible application as a new actinometer. This photochromic system covers a wide spectral absorption range, with intense bands in the UV and visible regions for the open-ring and closed-ring isomers, respectively. Very high ring-closure quantum yield values were obtained, in contrast with the low ring-opening quantum yields, which are nevertheless high enough to exploit 1 as an actinometer.

Biological prognostic factors for early stage completely resected non-small cell lung cancer.

Background And Objectives: The different and unpredictable outcomes in early-stage non-small cell lung cancer patients requires urgent research concerning the biological pathway of this neoplasm. Our study investigated the frequency of expression and the clinicopathologic and prognostic significance of a series of biological markers in stage I and II resected non-small cell lung cancer.

Methods: A total of 99 cases of pathologic stage I and II were analyzed.

Locally advanced rectal cancer: a multivariate analysis of outcome risk factors.

Background And Objectives: Stages II and III rectal tumors are known as locally advanced rectal cancer (LARC) because they are characterized by a high incidence of local and distant relapses and a low probability of long-term survival. Adjuvant treatments have been advocated to ameliorate overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) without a univocal beneficial trend. The aim of this study was to identify the independent predictive factors of OS, LRFS, and MFS which could best select patients for adjuvant treatment of LARC.

[Effect of octreotide on the hepatic metastasis of human colorectal cancer: an experimental model in athymic mice].

The aim of this randomized study was to determine the effects of octreotide therapy on the growth and development of experimental liver metastases from a human colonic cancer cell line (HT 29) in nude mice model. No important and significant difference could be found between mice, lungs and liver weights of both groups as well as lung metastatization; indeed, significant was the difference between groups concerning liver, metastases (the majority of them were in treated group): in spite of the small number of data collected, which does not allow to draw any conclusion on the efficacy of this drug on liver metastases, we believe that octreotide therapy does not affect dramatically the growth and development of liver metastases from a human colon cancer.

Hepatoid carcinoma of the stomach: is it still an unusual anatomo-clinical entity? Six cases-report.

Hepatoid carcinoma of the stomach is a rare neoplasm (especially in western countries) characterized by high levels of serum alpha-fetoprotein (AFP), the presence of "hepatoid foci" inside the gastric tumor and poor prognosis, due to the earlier onset of liver metastases. We treated six patients for hepatoid carcinoma of the stomach between 1990 and 1997. The female to male ratio was 1:1, the average age was 71 (54-81) and the average AFP-level was 1160 ng/ml (603-1531).

Adenocarcinoma arising from a recurrent fistula-in-ano.

Anal fistulas are frequent events which often recur after an inadequate surgical treatment. Nevertheless their evolution into malignant diseases is infrequently observed. The authors report one case of mucinous adenocarcinoma arising out of a recurrent, long-lasting fistula-in-ano.

[Perioperative changes in the plasma levels of fibrinogen and D-dimer during laparoscopic cholecystectomy: the preliminary results of a prospective randomized clinical study].

Aim: Considering that laparoscopic procedure is associated with increased resistance to lower-limb venous return and subsequent stasis, with possible implications in terms of thromboembolic complications, the aim of our study was to investigate prospectively the coagulative-fibrinolytic profile, in laparoscopic and open cholecystectomy, in patients randomly alloted to receive or not preoperative heparin.

Methods: We prospectively analyzed 36 patients (20 laparoscopic and 16 open) and we randomly divided the patients in two groups: Group-A (28 patients--16 laparoscopic and 12 open) didn't take any preoperative thromboprophylaxis, Group-B (8 patients--4 laparoscopic and 4 open) took preoperative subcutaneous heparin. We took blood venous samples before surgery, at time 0 and + 30 min.

Pancreatic regeneration after subtotal distal resection in rats. Effects of bombesin and octreotide by the in vivo bromodeoxyuridine uptake technique.

Forty male Wistar rats were randomly allocated to four treatment groups after 90% distal pancreatectomy: group A (control) received saline (0.5 ml subcutaneously); group B received bombesin (BBS; 10 microg/kg intraperitoneally); group C received octreotide (2.5 microg/kg subcutaneously), and group D received BBS and octreotide.

Bombesin-induced pancreatic regeneration in pigs is mediated by p46Shc/p52Shc and p42/p44 mitogen-activated protein kinase upregulation.

Background: In several animal species the pancreas has the capacity to partially regenerate in a self regulating process. A complex network of growth factors modulates this process. There is evidence that bombesin stimulates pancreatic regeneration in rodents.

Transcranial Doppler monitoring during carotid endarterectomy: is it appropriate for selecting patients in need of a shunt?

Purpose: This report summarizes our experience in evaluating a series of 168 patients who underwent a total of 175 carotid endarterectomy procedures under local anesthesia. Patients were monitored by stump pressure (SP) measurement and transcranial Doppler scanning (TCD). The need for shunting was compared between SP/TCD flow velocity reduction and the awake response (gold standard).

Eversion versus conventional carotid endarterectomy: a prospective study.

Objectives: To analyse comparatively eversion and conventional CEA for later association with restenosis, perioperative stroke/death and ipsilateral cerebrovascular events (early, late, disabling and non-disabling).

Design: Prospective non-randomised clinical study.

Materials And Methods: A total of 469 patients underwent 514 procedures; 274 (53%) eversion CEA and 240 (47%) conventional CEA.

["Hepatoid" gastric tumor].

In this study the Authors describe two cases of hepatoid adenocarcinoma of the stomach: one is characterized by the presence of alpha-fetoprotein (AFP) high levels of the serum both pre and post-operating and by the very positive response to the adjuvant chemotherapy (how the return to the normality of such values demonstrates). The other is instead characterized by the presence of post operating hepatic metastasis, event which is very frequent in this kind of neoplasm, but presents many problems concerning the differential histological diagnostics with the primitive hepatocarcinoma (problems which are nowadays not completely solved). Moreover the Authors relate to this study the revision of the international literature of the main characteristics and of prognosis of this particular and rare neoplasm.

Surgical care in octogenarians.

The general surgical profile of octogenarians compared with that of younger patients, and risk factors predictive of operative mortality and morbidity, were determined retrospectively using a computer database for all patients admitted between 1989 and 1993. There were 934 admissions of octogenarians and surgery was performed in 447 cases (47.9 percent).

Postoperative intraabdominal abscesses: percutaneous versus surgical treatment.

The optimal treatment of postoperative intraabdominal abscesses has not yet been defined and mortality and morbidity remain high. In this retrospective study 2.310 laparotomies were reviewed.

Computerised tomography findings as a risk factor in carotid endarterectomy: early and late results.

Objectives: To evaluate whether preoperative CT evidence of brain infarction is associated with an increased risk of early and late stroke and death in patients undergoing CEA.

Design: Retrospective clinical study.

Materials And Methods: We evaluated 844 CT scanning records from 893 patients undergoing CEA from 1986-1994: 43% (367) CT positive for cerebral infarction and 57% (477) negative.

Ultrasonography in the management of acute appendicitis.

Background: Ultrasonography (US) shows promise in the diagnosis of acute appendicitis.

Methods: The authors present their own experience in ultrasonography (US) employed in the diagnosis of appendicitis, based on 40 patients admitted to the Department of Surgery of the University of Perugia.

Results: US was found to be easily obtainable and reliable; it had good specificity and sensitivity, was not very time consuming, and had a good cost/benefit ratio.

Carotid endarterectomy contralateral to an occluded carotid artery: a retrospective case-control study.

Objectives: To analyse whether contralateral occlusion represents an additional perioperative risk factor in carotid endarterectomy (CEA), and whether long-term survival after surgery in patients with contralateral occlusion differs from that of patients without.

Design: Retrospective clinical study.

Setting: Vascular Surgery Unit, Department of Surgery, University of Perugia, Perugia, Italy.

Prospective study of 713 below-knee amputations for ischaemia and the effect of a prostacyclin analogue on healing. Hawaii Study Group.

In 51 hospitals in six European countries 713 patients requiring below-knee amputation for ischaemic disease were studied prospectively. The patients were allocated randomly to receive standard postoperative treatment or standard treatment plus intravenous infusion of the prostacyclin analogue iloprost for 6 h per day over 14-21 days. Healing of the amputation stump and the need for reamputation at a higher level were similar in the two groups.

[The surgeon's role in the treatment of cholelithiasis].

From a surgeon's point of view, the management of biliary tract calculi can be simplified as follows: 1) In the asymptomatic patients a prophylactic surgery is not justified. 2) In the symptomatic patients the cholecystectomy is by far the best procedure as it eliminates the symptoms and it prevents the complications. 3) If performed in elective and good-risk patients, this surgical technique is without morbidity and mortality.