A treatment method for main bronchus fistula after pneumonectomy via median sternotomy was described by P. Abruzzini in 1961. This operation is performed in an area not involved with infection. ...Fifteen patients underwent the procedure in our surgical department; one of them died of myocardial infarction while all the others survived for different periods of time, closely associated with the original disease; seven were long-term survivors. The transmediastinal approach seems an effective means of managing such a difficult complication.
Type Ia Supernovae (SNe Ia) are widely used to measure the expansion of the Universe. To perform such measurements the luminosity and cosmological redshift (\(z\)) of the SNe Ia have to be ...determined. The uncertainty on \(z\) includes an unknown peculiar velocity, which can be very large for SNe Ia in the virialized cores of massive clusters. We determine which SNe Ia exploded in galaxy clusters. We then study how the correction for peculiar velocities of host galaxies inside the clusters improves the Hubble residuals. Using 145 SNe Ia from the Nearby Supernova Factory we found 11 candidates for membership in clusters. To estimate the redshift of a cluster we applied the bi-weight technique. Then, we use the galaxy cluster redshift instead of the host galaxy redshift to construct the Hubble diagram. For SNe Ia inside galaxy clusters the dispersion around the Hubble diagram when peculiar velocities are taken into account is smaller in comparison with a case without peculiar velocity correction, with a \(wRMS=0.130\pm0.038\) mag instead of \(wRMS=0.137\pm0.036\) mag. The significance of this improvement is 3.58 \(\sigma\). If we remove the very nearby Virgo cluster member SN2006X (\(z<0.01\)) from the analysis, the significance decreases to 1.34 \(\sigma\). The peculiar velocity correction is found to be highest for the SNe Ia hosted by blue spiral galaxies, with high local specific star formation rate and smaller stellar mass, seemingly counter to what might be expected given the heavy concentration of old, massive elliptical galaxies in clusters. As expected, the Hubble residuals of SNe Ia associated with massive galaxy clusters improve when the cluster redshift is taken as the cosmological redshift of the SN. This fact has to be taken into account in future cosmological analyses in order to achieve higher accuracy for cosmological redshift measurements. Here we provide an approach to do so.
Surgical treatment of digestive arteries aneurysms Illuminati, G; Caliò, F G; Bertagni, A ...
European review for medical and pharmacological sciences,
1997 Jan-Jun, Letnik:
1, Številka:
1-3
Journal Article
Recenzirano
Eight patients of a mean age of 56.4 years, have been operated on for 9 digestive arteries aneurysms in a 7-years-period. Sites of aneurysmal disease included 3 splenic, 3 superior mesenteric, 2 ...hepatic, and 1 left gastric arteries. Five patients (62.5%) were asymptomatic, while 3 (37.5%) presented with symptoms. Three patients (37.5%) presented associated aortic lesions consisting in 2 infrarenal aneurysms and 1 aorto-iliac stenosis. Of the 9 arteries treated, 5 were revascularized. Restaurative operations included 1 reconstructive endoaneurysmorraphy, 3 retrograde by-pass grafts (2 Dacron and 1 PTFE), and 1 antegrade by-pass graft (Dacron) from the coeliac aorta. There were no post-operative deaths. Mean length of follow-up was 47.8 months. No patient presented with late intestinal or operation related problems.
Ingestion of foreign bodies (FB) seems to be a relatively common occurrence in certain classes of people. The majority of ingested objects reach the stomach end 80% of these pass spontaneously ...without complications. However nearly 20% of FB that pass from the stomach result in complication distally such to required a surgical operation. The authors report a case of chicken bone perforation of the ileus, which was diagnosed by surgical operation. The case reported is of interest for several reason. The lack of condition that can predispose patients to accidental ingestion of FB, no specific history of FB ingestion and the impossibility to detect chicken bones on plain radiography.
Lung tumors invading the chest wall are classed as belonging to the T3 group and are considered potentially resectable. Their management, however, is controversial, and extrapleural resection, when ...possible, is preferred to en bloc resection which is regarded as a far more invasive and dangerous operation. Five year survival rates for completely resected cases range in the literature from 25 to 35%, but survival rates are much worse if lymph node metastases are present. These poor outcomes have prompted the development of combined surgical approaches: preoperative radiation therapy, with or without chemotherapy, has been used with an improvement in resectability rates, but only modest results in terms of median survival; in a number of case series, increased operative morbidity and mortality have been reported with this approach. The present report relates to 122 patients treated by en bloc (20 cases) or extrapleural (102 cases) resection, 31 of whom also received neoadjuvant treatment. The operative mortality was 4.6%. Median survival was 17 months after en bloc resection and 19 months after extrapleural resection. Though no statistically significant difference was found, extrapleural resection would appear to yield better results than the en bloc procedure.
EDITOR,--We are pleased to read that the junior doctors' conference endorsed a motion arguing that implementation of the new deal may jeopardise the training of some higher specialist trainees. 1 All ...the enrolled higher surgical trainees in cardiothoracic surgery currently working in the United Kingdom strongly support this view and believe that it cannot be dismissed by facile jibes of the type made by S Hajioff at the conference.
Acute ischemia of the lower limbs Illuminati, G; Bertagni, A; Calio, F G ...
Rivista europea per le scienze mediche e farmacologiche,
1996 Jan-Feb, Letnik:
18, Številka:
1
Journal Article
One hundred nineteen patients operated upon for acute ischemia of the lower limbs have been retrospectively reviewed, in order to evaluate the influence of the condition on outcome, and the patterns ...of treatment. Fifty six per cent of the patients were males and 42% females, 68.4% had an history of aorto-iliac obstructive disease; 51.2% of the ischemias were due to arterial thrombosis and 48.8% to embolism, in 12.5% of the cases etiology was unknown. Thrombosis were more frequent in younger patients' population (mean age 59.8 years) compared to embolism (mean age 69 years), even if the mean age of patients bearing an ischemia of embolic type has risen, in the last 10 years: 62.1% were due to atrial fibrillation and 50% occurred on pathologic arteries, patients with arterial obstructive disease presented a higher incidence of arrest of embolic material at the common femoral artery bifurcation. Women's mean age was significantly higher then that of men (70.9 vs. 59 yrs.). Embolism was more frequent in women than in men (64 vs 42.2), whereas thrombosis was more frequent in men than women (57.8 vs 36%). There were more deaths in women than men (30.8 vs 20.8%), but more amputations in men than women (37.3 vs 17.3%). Embolism of arterial origin include 15.2% of all acute ischemias and 31% of all embolisms, and their site of origin is often unknown, particularly when it is located in the thoracic aorta, which mandate a complete arteriography and eventually a CT-Scan of the thorax and the abdomen. A lower limb phlebitis, associated with an acute ischemia mandates the search of a patent foramen ovale, and an heparin induced thrombocytopenia. Surgical treatment is directed towards obstruction removal (embolectomy, by-pass) and towards the treatment of the causative agent (aortic endarterectomy, caval filter, anticoagulants). Post-operative thrombolysis may be beneficial in case of distal residual thrombus after embolectomy. An higher mortality rate has been observed in acute ischemias due to embolism rather than thrombosis (31 vs 19.6%) and more major amputations in thrombosis than in embolism (37.7 vs 17.2%). Overall mortality rate has been of 25%, with an amputation rate of 28%. Present results have been compared with those of the literature, both agree on some changes over the last 20 years, concerning the incidence of different mechanisms of acute ischemias and their prognosis.
