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Search Results: 1 - 10 of 637 matches for " Enzo Andorno "
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Cavo-portal transposition in rat: a new simple model
Stefano Di Domenico, Giulio Bovio, Maximiliano Gelli, Ferruccio Ravazzoni, Enzo Andorno, Damiano Cottalasso, Umberto Valente
BMC Surgery , 2007, DOI: 10.1186/1471-2482-7-18
Abstract: Spontaneous porto-systemic shunts are induced by subcutaneous transposition of the spleen. The presence of porto-caval shunts through the spleen permits the interruption of the main portal vein without splanchnic hemodynamic consequences. Cavo-portal transposition is achieved by anastomosing the inferior vena cava and the main portal vein after division of the pancreatic-duodenal vein.Selective angiography revealed total splanchnic blood diversion to the systemic venous circulation through the neoformed collaterals; macroscopical examination showed the absence of any signs of acute portal hypertension with normal liver and gut appearance.This model of cavoportal transposition is simple, effective and it simulates the clinical hemodynamic condition since the porto-systemic shunts induced by splenic subcutaneous transposition correspond to the physiological inframesocolic collaterals during chronic portal thrombosis in man.Thrombosis of the portal vein has been a formidable challenge in liver transplantation and it was historically considered an absolute contraindication [1]. Refinements in surgical techniques in the last decades allow surgeons to overcome portal thrombosis with progressive extensions, by using phlebothrombectomy, venous jump grafts or portal vein arterialization [2,3]. Moreover, the use of caval blood as unique portal inflow has been used recently to performed liver transplantation in patients with diffuse splanchnic thrombosis: in this setting graft portal flow has been obtained by end-to-end or end-to-side porto-caval anastomosis or by reno-portal anastomosis [4-6].Patients with chronic thrombosis without portal hypertension are the best candidates due to the presence of wide spontaneous porto-systemic shunts that completely supply the splancnic vein drainage [7].The results of these techniques are still heterogeneous and further experimental and clinical studies are needed to clarify the role of spontaneous porto-systemic shunt on liver function a
Biomedicine and international human rights law: in search of a global consensus
Andorno,Roberto;
Bulletin of the World Health Organization , 2002, DOI: 10.1590/S0042-96862002001200010
Abstract: global challenges raised by biomedical advances require global responses. some international organizations have made significant efforts over the last few years to establish common standards that can be regarded as the beginning of an international biomedical law. one of the main features of this new legal discipline is the integration of its principles into a human rights framework. this strategy seems the most appropriate, given the role of "universal ethics" that human rights play in our world of philosophical pluralism. in addition to the general standards that are gradually being established, a widespread consensus exists on the urgency of preventing two specific procedures: human germ-line interventions and human reproductive cloning.
What is the role of 'human nature' and 'human dignity' in our biotechnological age?
Roberto Andorno
Amsterdam Law Forum , 2011,
Abstract:
Grammatica e acquisizione dell'italiano L2
Cecilia Andorno
Italiano LinguaDue , 2009, DOI: 10.6092/2037-3597/450
Abstract: Gli apprendenti richiedono l’insegnamento della grammatica e, data la complessità e la pervasività del sistema grammaticale italiano, il docente deve dotarsi di strumenti e conoscenze per rispondere adeguatamente. L’intervento, attraverso lo sviluppo del sistema verbale, prende in considerazione una descrizione grammaticale statica e una descrizione dinamica, procedurale e funzionale pensata per descrivere l’uso che di tale sistema ne fanno i parlanti. L’insegnante per poter svolgere il ruolo di mediatore tra ciò che l’apprendente sa e il modo in cui il sistema è organizzato, dovrebbe conoscere il sistema nella sua interezza e complessità, non solo secondo un modello descrittivo del sistema finale, ma anche secondo le operazioni necessarie alla ricostruzione del sistema che l’apprendente mette in atto.
Biomedicine and international human rights law: in search of a global consensus
Andorno Roberto
Bulletin of the World Health Organization , 2002,
Abstract: Global challenges raised by biomedical advances require global responses. Some international organizations have made significant efforts over the last few years to establish common standards that can be regarded as the beginning of an international biomedical law. One of the main features of this new legal discipline is the integration of its principles into a human rights framework. This strategy seems the most appropriate, given the role of "universal ethics" that human rights play in our world of philosophical pluralism. In addition to the general standards that are gradually being established, a widespread consensus exists on the urgency of preventing two specific procedures: human germ-line interventions and human reproductive cloning.
Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt
Giovanni Varotti,Enzo Andorno,Marco Casaccia,Stefano Di Domenico,Giuliano Bottino,Pietro Diviacco,Nicola Morelli,Chiara Ferrari,Roberto Ferrante,Umberto Valente
Journal of Transplantation , 2010, DOI: 10.1155/2010/570392
Abstract: Two-stage liver transplantation (LT) has been reported for cases of fulminant liver failure that can lead to toxic hepatic syndrome, or massive hemorrhages resulting in uncontrollable bleeding. Technically, the first stage of the procedure consists of a total hepatectomy with preservation of the recipient's inferior vena cava (IVC), followed by the creation of a temporary end-to-side porto-caval shunt (TPCS). The second stage consists of removing the TPCS and implanting a liver graft when one becomes available. We report a case of a two-stage total hepatectomy and LT in which a temporary end-to-end anastomosis between the portal vein and the middle hepatic vein (TPMHV) was performed as an alternative to the classic end-to-end TPCS. The creation of a TPMHV proved technically feasible and showed some advantages compared to the standard TPCS. In cases in which a two-stage LT with side-to-side caval reconstruction is utilized, TPMHV can be considered as a safe and effective alternative to standard TPCS.
Liver Retransplantation in Adults: The Largest Multicenter Italian Study
Umberto Maggi, Enzo Andorno, Giorgio Rossi, Luciano De Carlis, Umberto Cillo, Fabrizio Bresadola, Vincenzo Mazzaferro, Andrea Risaliti, Paolo Bertoli, Dario Consonni, Francesco Barretta, Tullia De Feo, Mario Scalamogna
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0046643
Abstract: This study is the largest Italian survey on liver retransplantations (RET). Data report on 167 adult patients who received 2 grafts, 16 who received 3 grafts, and one who received 4 grafts over a 11 yr period. There was no statistically significant difference in graft survival after the first or the second RET (52, 40, and 29% vs 44, 36, and 18% at 1,5,and 10 yr, respectively: Log-Rank test, p = 0.30). Survivals at 1, 5, and 10 years of patients who underwent 2 (n = 151) or 3 (n = 15) RETs, were 65, 48,and 39% vs 59, 44, and 30%, respectively (p = 0.59). Multivariate analysis of survival showed that only the type of graft (whole vs reduced) was associated with a statistically significant difference (HR = 3.77, Wald test p = 0. 05); the donor age appeared to be a relevant factor as well, although the difference was not statistically significant (HR = 1.91, Wald test p = 0.08). Though late RETs have better results on long term survival relative to early RETs, no statistically significant difference can be found in early results, till three years after RET. Considering late first RETs (interval>30 days from previous transplantation) with whole grafts the difference in graft survival in RETs due to HCV recurrence (n = 17) was not significantly different from RETs due to other causes (n = 53) (65–58 and 31% vs 66–57 and 28% respectively at 1–5 and 10 years, p = 0.66).
Sister Joseph's nodule in a liver transplant recipient: Case report and mini-review of literature
Fabrizio Panaro, Enzo Andorno, Stefano Di Domenico, Nicola Morelli, Giuliano Bottino, Rosalia Mondello, Marco Miggino, Tomasz M Jarzembowski, Ferruccio Ravazzoni, Marco Casaccia, Umberto Valente
World Journal of Surgical Oncology , 2005, DOI: 10.1186/1477-7819-3-4
Abstract: A 59-years-old Caucasian female underwent liver transplant for end stage liver disease due to hepatitis C with whole graft from cadaveric donor in 2003. After transplantation the patient developed multiple subcutaneous nodules in the umbilical region and bilateral inguinal lymphadenopathy. The excision biopsy of the umbilical mass showed the features of a poorly differentiated papillary serous cystadenocarcinoma. Computed tomographic scan and transvaginal ultrasonography were unable to demonstrate any primary lesion. Chemotherapy was start and the dosage of the immunosuppressive drugs was reduced. To date the patient is doing well and liver function is normal.The umbilical metastasis can arise from many sites. In some cases, primary tumor may be not identified; nonetheless chemotherapy must be administrated based on patient's history, anatomical and histological findings.Metastases to the umbilicus are universally referred to as Sister Joseph's (or Sister Mary Joseph's) nodule. Etiology is related to the presence of primary malignant disease in the abdominal cavity or occasionally in the chest and/or breast [1-5]. Historically, Sister Mary Joseph (1856–1939) was a surgical assistant under the guidance of Dr. William Mayo. She was the first one to note the connection between the umbilical nodule and intra-abdominal cancer. The first case reporting the presence of Sister Mary Joseph's nodule was in 1864 by Storer, however; Hamilton Bailey was the first one to use the term "Sister Mary Joseph's nodule.Although skin metastasis is rare and range between 5% and 9%, it is estimated that 1% to 3% of abdomino-pelvic tumors metastasize to the umbilicus [2,3,5]. The most common primary neoplasm is adenocarcinoma (75%), more rarely squamous cell carcinoma followed by undifferentiated tumors or carcinoid can metastasize to umbilicus. In men, gastrointestinal tract (55%) is the most common location of the primary neoplasm that metastasizes to the umbilicus, followed by stomach, c
Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt
Giovanni Varotti,Enzo Andorno,Marco Casaccia,Stefano Di Domenico,Giuliano Bottino,Pietro Diviacco,Nicola Morelli,Chiara Ferrari,Roberto Ferrante,Umberto Valente
Journal of Transplantation , 2010, DOI: 10.1155/2010/570392
Abstract: Two-stage liver transplantation (LT) has been reported for cases of fulminant liver failure that can lead to toxic hepatic syndrome, or massive hemorrhages resulting in uncontrollable bleeding. Technically, the first stage of the procedure consists of a total hepatectomy with preservation of the recipient's inferior vena cava (IVC), followed by the creation of a temporary end-to-side porto-caval shunt (TPCS). The second stage consists of removing the TPCS and implanting a liver graft when one becomes available. We report a case of a two-stage total hepatectomy and LT in which a temporary end-to-end anastomosis between the portal vein and the middle hepatic vein (TPMHV) was performed as an alternative to the classic end-to-end TPCS. The creation of a TPMHV proved technically feasible and showed some advantages compared to the standard TPCS. In cases in which a two-stage LT with side-to-side caval reconstruction is utilized, TPMHV can be considered as a safe and effective alternative to standard TPCS. 1. Introduction The two-stage total hepatectomy with temporary portocaval shunt and subsequent liver transplantation (LT) were first described by Ringe et al. [1] in 1988. The rationale for the procedure is based upon the concept that patients with fulminant hepatic failure or graft failure that can lead to a toxic hepatic syndrome, or massive haemorrhages resulting in uncontrollable bleeding, can benefit from urgent removal of the native liver followed by LT when an organ becomes available [2, 3]. The first stage of the procedure consists of a total hepatectomy with preservation of the recipient’s inferior vena cava (IVC) and suture of the three hepatic veins. Then a temporary end-to-side portocaval shunt (TPCS) is created to re-establish the splanchnic outflow during the anhepatic phase. The second stage consists of removing the TPCS and implanting the liver graft when one becomes available [4]. We report a case of a two-stage total hepatectomy and LT in which a temporary end-to-end anastomosis between the portal vein and the middle hepatic vein (TPMHV) was performed as an alternative to the classic end-to-end TPCS. 2. Case Report A 43-year-old woman underwent urgent laparotomy for spontaneous massive rupture of a subcapsular liver hematoma associated with HELLP syndrome. The right lobe of the liver was entirely replaced by a large hematoma and areas of necrosis, and there were deep ruptures in both lobes. After establishing that neither conservative surgical treatments nor partial resections would have been effective; a total hepatectomy was performed to
Everyday bioethics: reflections on bioethical choices in daily life
Biller-Andorno Nikola
Bulletin of the World Health Organization , 2003,
Abstract:
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