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Search Results: 1 - 10 of 406957 matches for " Stefano M Giulini "
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Collagen-based biological glue after Appleby operation for advanced gastric cancer
Gianluca Baiocchi,Nazario Portolani,Federico Gheza,Stefano M Giulini
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i35.4044
Abstract: Pancreatic fistula is a common complication of distal pancreatectomy; although various surgical procedures have been proposed, no clear advantage is evident for a single technique. We herein report the case of a 38-year-old patient affected by an advanced gastric carcinoma infiltrating the pancreas body, with extensive nodal metastases involving the celiac trunk, who underwent total gastrectomy with lymphadenectomy, distal pancreatectomy and resection en bloc of the celiac trunk (Appleby operation). At the end of the demolitive phase, the pancreatic stump and the aorta at the level of the celiac ligature were covered with a layer of Tachosil , a horse collagen sponge made with human coagulation factors (fibrinogen and thrombin). Presenting this case, we wish to highlight the possible sealing effect of this product and hypothesize a role in preventing pancreatic fistula and postoperative lymphorrhagia from extensive nodal dissection.
Possible additional value of 18FDG-PET in managing pancreas intraductal papillary mucinous neoplasms: Preliminary results
Gian Baiocchi, Nazario Portolani, Francesco Bertagna, Federico Gheza, Claudio Pizzocaro, Raffaele Giubbini, Stefano M Giulini
Journal of Experimental & Clinical Cancer Research , 2008, DOI: 10.1186/1756-9966-27-10
Abstract: Cystic pancreas tumours are observed with increasing frequency in asymptomatic patients as incidental findings during US or CT abdominal imaging. Pancreatic resection, the only available therapy, may represent an over-treatment due to the low malignant potential of more than half of these lesions [1]. Within the whole group of cystic pancreas tumours, preoperative imaging, including magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound, usually allows three main lesions to be differentiated: serous adenoma, mucinous tumour and IPMN (intraductal papillary mucinous neoplasm) [2]. While in the two former tumours the indications are well recognised (radiological follow-up for serous and resection for mucinous neoplasms), IPMN still represents a more critical field, potentially bearing adenoma, in situ carcinoma or invasive carcinoma; these lesions cannot be differentiated with sufficient accuracy by currently available imaging techniques.In the search for a diagnostic tool improving malignant IPMN preoperative detection accuracy, 18FDG-PET was poorly investigated in the published series. This paper's aim is to discuss the potential of this functional imaging technique in managing IMPN, based on a preliminary monocentric experience.In the period 2003–2005, 28 patients with a conclusive diagnosis of IPMN were observed in the Surgical Clinic of Brescia University. The radiological workup included magnetic resonance cholangiopancreatography (MRCP) in 26 patients and CT scan in 23 patients. Endoscopic ultrasonography was performed in 13 patients (in 6 cases with fine needle aspiration of the cystic contents). MRCP was conducted with noncontrast, T2-weighted, fat-suppressed, HASTE sequences, T1-weighted, fat-suppressed WIBE sequences, and dynamic gadolinium administration; postcontrast MR images were acquired on transverse, coronal and axial planes. 16-row multidetector CT scan was performed with water gastric filling and endovenous contrast medium inje
Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis
Edoardo Cervi, Stefano Bonardelli, Giuseppe Battaglia, Federico Gheza, Roberto Maffeis, Franco Nodari, Roberto Maroldi, Stefano M Giulini
Thrombosis Journal , 2011, DOI: 10.1186/1477-9560-9-13
Abstract: A woman of 62 years presented with a severe pain left forearm appeared 10 days ago, with a worsening trend. The same symptoms appeared after 5 days also in the right forearm. Physical examination showed the right arm slightly hypothermic, with radial reduced pulse in presence of reduced sensitivity. The left arm was frankly hypothermic, pulse less on radial and with an ulnar humeral reduced pulse, associated to a decreased sensitivity and motility.Clinical history shows a chronic headache for which the patient took a daily basis for years Cafergot suppository (equivalent to 3.2 mg of ergotamine).From about ten days had begun therapy with itraconazole for vaginal candidiasis. The Color-Doppler ultrasound shown arterial thrombosis of the upper limbs (humeral and radial bilateral), with minimal residual flow to the right and no signal on the humeral and radial left artery.Angiography revealed progressive reduction in size of the axillary artery and right humeral artery stenosis with right segmental occlusions and multiple hypertrophic collateral circulations at the elbow joint. At the level of the right forearm was recognizable only the radial artery, decreased in size. Does not recognize the ulnar, interosseous artery was thin. To the left showed progressive reduction in size of the distal subclavian and humeral artery, determined by multiple segmental steno-occlusion with collateral vessels serving only a thin hypotrophic interosseous artery.Arteriographic findings were compatible with systemic drug-induced disease. The immediate implementation of thrombolysis, continued for 26 hours, with heparin in continuous intravenous infusion and subsequent anticoagulant therapy allowed the gradual disappearance of the symptoms with the reappearance of peripheral pulses.Angiography showed regression of vasospasm and the resumption of flow in distal vessels. The patient had regained sensitivity and motility in the upper limbs and bilaterally radial and ulnar were present.A 62 ye
Intraductal papillary mucinous neoplasm of the pancreas (IPMN): clinico-pathological correlations and surgical indications
Gian Baiocchi, Nazario Portolani, Guido Missale, Carla Baronchelli, Federico Gheza, Massimiliano Cantù, Luigi Grazioli, Stefano M Giulini
World Journal of Surgical Oncology , 2010, DOI: 10.1186/1477-7819-8-25
Abstract: Retrospective analysis of a prospectively collected Western series of IPMN.Forty cases of IPMN were analysed (1992-2007). Most patients were symptomatic (72.5%); cholangio-MRI had the best diagnostic accuracy both for the tumour nature (83.3%) and for the presence of malignancy (57.1%). ERCP was done in 8 cases (20%), and the results were poor. Thirteen patients were treated by pancreatic resection and 27 were maintained in follow-up. Total pancreatectomy was performed in 46% of the cases; in situ and invasive carcinoma were recognized in 15.4% and 38.4% of the cases, respectively. The mean follow-up was 42 months (range 12-72). One only patients with nodal metastases died 16 months after the operation for disease progression, while 91.6% of the operated patients are disease free. Out of the 27 not resected patients, 2 out of 4 presenting a lesion at high risk for malignancy died, while the remaining are in good conditions and disease free, with a mean follow-up of 31 months.Therapeutic indication for IPMNs is mainly based upon radiological evaluation of the risk of malignancy. While the main duct tumours should be resected, preserving whenever possible a portion of the gland, the secondary ducts tumours may be maintained under observation, in absence of radiological elements of suspicion such as size larger than 3 cm, or a wall greater than 3 mm or nodules or papillae in the context of the cyst.In the group of cystic neoplasms of the pancreas, the intraductal papillary mucinous tumor (IPMN) represents a recently characterized entity; this denomination was introduced in 1996 [1], and comprises a group of lesions that differ from cystic mucinous neoplasms because of a direct communication with the Wirsung duct and the absence of ovarian-type stroma [2]; it is characterized by a papillary growth of the ductal epithelium with rich mucin production and cystic expansion of the interested duct (Fig. 1).IPMN was firstly described in 1982 [3]; a sharp increase in the freque
On the possibility of spinorial quantization in the Skyrme model
Domenico Giulini
Physics , 1993, DOI: 10.1142/S0217732393001641
Abstract: We consider the configuration space of the Skyrme model and give a simple proof that loops generated by full spatial rotations are contractible in the even-, and non-contractible in the odd-winding-number sectors.
On the configuration space topology in general relativity
Domenico Giulini
Physics , 1993,
Abstract: The configuration-space topology in canonical General Relativity depends on the choice of the initial data 3-manifold. If the latter is represented as a connected sum of prime 3-manifolds, the topology receives contributions from all configuration spaces associated to each individual prime factor. There are by now strong results available concerning the diffeomorphism group of prime 3-manifolds which are exploited to examine the topology of the configuration spaces in terms of their homotopy groups. We explicitly show how to obtain these for the class of homogeneous spherical primes, and communicate the results for all other known primes except the non-sufficiently large ones of infinite fundamental group.
What is the Geometry of Superspace ?
Domenico Giulini
Physics , 1993, DOI: 10.1103/PhysRevD.51.5630
Abstract: We investigate certain properties of the Wheeler-DeWitt metric (for constant lapse) in canonical General Relativity associated with its non-definite nature. Contribution to the conference on Mach's principle: "From Newtons Bucket to Quantum Gravity", July 26-30 1993, Tuebingen, Germany
On Galilei Invariance in Quantum Mechanics and the Bargmann Superselection Rule
Domenico Giulini
Physics , 1995, DOI: 10.1006/aphy.1996.0069
Abstract: We reinvestigate Bargmann's superselection rule for the overall mass of $n$ particles in ordinary quantum mechanics with Galilei invariant interaction potential. We point out that in order for mass to define a superselection rule it should be considered as a dynamical variable. We present a minimal extension of the original dynamics in which mass it treated as dynamical variable. Here the classical symmetry group turns out to be given by an $\reals$-extension of the Galilei group which formerly appeared only at the quantum level. There is now no obstruction to implement an action of the classical symmetry group on Hilbert space. We include some critical comments of a general nature on formal derivations of superselection rules without dynamical context.
Ashtekar Variables in Classical General Realtivity
Domenico Giulini
Physics , 1993, DOI: 10.1007/3-540-58339-4_16
Abstract: This paper contains an introduction into Ashtekar's reformulation of General Relativity in terms of connection variables. To appear in "Canonical Gravity - From Classical to Quantum", ed. by J. Ehlers and H. Friedrich, Springer Verlag (1994).
A Euclidean Bianchi Model Based On $S^3/D_8^*$
Domenico Giulini
Physics , 1995, DOI: 10.1016/0393-0440(95)00051-8
Abstract: We explain how the round four-sphere can be sliced along homogeneous 3~-~manifolds of topology $S^3/D_8^*$. This defines a Euclidean Bianchi type IX model for Einstein's equations with cosmological constant. The geometric properties of this model are investigated.
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