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The duodenal window approach to pancreatoduodenectomy
Giovanni Domenico Tebala,Jacopo Desiderio,Domenico Di Nardo,Alessandro Gemini,Roberto Cirocchi 한국간담췌외과학회 2024 Annals of hepato-biliary-pancreatic surgery Vol.28 No.2
The pancreatoduodenectomy (PD) technique is yet to be standardized. One of the most difficult passages in PD is the mobilization of the second, third, and fourth parts of the duodenum. This maneuver is classically performed from the supramesocolic space after the division of the gastrocolic ligament, but traction on the transverse mesocolon and the superior mesenteric pedicle can cause bleeding from the venous and arterial branches of the pancreatic head and uncinate process. We hereby describe a technique to access and mobilize the distal duodenum and proximal jejunum (D2 to J1) through the duodenal window and the Treitz’s foramen, performing an almost complete Kocher’s maneuver before opening the gastrocolic ligament and mobilizing the hepatic flexure. The anatomical basis and the surgical technique of the duodenal-window-first PD are discussed. The duodenal-window-first approach is a standardizable step of PD that allows an easy and safe mobilization of D2 to J1. This technique has been applied to 15 cases of PD, both open and robotic, with no specific morbidity. Therefore, we propose the adoption of the duodenal-window-first technique as a routine standardized step of PD.
REMARKS ON LEVI HARMONICITY OF CONTACT SEMI-RIEMANNIAN MANIFOLDS
Domenico Perrone 대한수학회 2014 대한수학회지 Vol.51 No.5
In a recent paper [10] we introduced the notion of Levi har- monic map f from an almost contact semi-Riemannian manifold (M,ϕ,ξ, η,g) into a semi-Riemannian manifold M ′ . In particular, we computed the tension field τ H (f) for a CR map f between two almost contact semi-Riemannian manifolds satisfying the so-called ϕ-condition, where H = Ker(η) is the Levi distribution. In the present paper we show that the condition (A) of Rawnsley [17] is related to the ϕ-condition. Then, we compute the tension field τ H (f) for a CR map between two arbitrary almost contact semi-Riemannian manifolds, and we study the concept of Levi pluriharmonicity. Moreover, we study the harmonicity on quasi- cosymplectic manifolds.
Domenico De Berardis,Luigi Olivieri,Gabriella Rapini,Serena Di Natale,Nicola Serroni,Michele Fornaro,Laura Orsolini,Alessandro Valchera,Alessandro Carano,Federica Vellante,Paola Annunziata Varasano,Ga 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.2
Objective: This study was performed to elucidate relationships between alexithymia, suicide ideation and homocysteine levels in drug-naïve outpatients with major depressive disorder (MDD). Methods: Sixty seven outpatients with MDD with melancholic features were evaluated by the means of the Hamilton Depression Rating Scale, the Toronto Alexithymia Scale (TAS–20), the Scale of Suicide Ideation, and homocysteine levels. Results: Alexithymic subjects showed higher scores on all scales and higher homocysteine levels. Regression analysis shown higher homocysteine levels and TAS-20’ “Difficulty in Describing Feelings” dimension, in turn being associated with higher suicide ideation. Conclusion: In conclusion, alexithymic MDD outpatients may characterize for homocysteine dysregulation that may be linked to suicide ideation, regardless depression’ severity. However, study limitations are discussed and must be considered.
Régions et autonomie locale en Italie
Domenico Sorace 한국지방자치법학회 2008 지방자치법연구(地方自治法硏究) Vol.8 No.3
L’Italie est une péninsule baignée par la mer Méditerranée où se trouvent aussi des îles qui lui sont reliées (dont la Sicile et la Sardaigne sont le plus importantes). Elle est longue de 1.300 km du nord au sud. Sa superficie est de 301.270 km² ; elle compte un peu moins de 60 millions d’habitants ; sa densité moyenne est de presque 196 habitants au km² (mais la densité est très variable, vue que le territoire est très montueux). Elle est un État unifié depuis le 1861 (avant il y avait dans la péninsule plusieurs États). Depuis 1946, après la chute du fascisme, elle est devenue une République démocratique et en 1957 a participé à la fondation de la Communauté Européenne. Sa Constitution a entrée en force en 1948 mais récemment (en 1999 et 2001) la grande part des articles qui traitent des Régions et des institutions locales ont été révisés.
Domenico Umberto De Rose,Alessandro Perri,Francesca Gallini,Francesca Priolo,Eloisa Tiberi,Giovanni Vento,Enrico Zecca 대한소아내분비학회 2019 Annals of Pediatirc Endocrinology & Metabolism Vol.24 No.2
We report a case of transient pseudohypoparathyroidism in a full-term newborn that presented at 20 hours of life with hypocalcemic seizures, hyperphosphatemia and raised parathormone levels. The diagnosis of pseudohypoparathyroidism was made according to biochemical investigations. The infant was treated with calcium supplementation and vitamin D analog therapy, and he remained stable and symptom-free with normal serum biochemistries during follow-up. We suggest that transient pseudohypoparathyroidism of the newborn (ntPHP) might be included among inactivating parathyroid hormone (PTH)/PTH-related protein signaling disorders as defined by the classification schema recently proposed by the European Pseudohypoparathyroidism Network. To the best of our knowledge, this is the first report in which the new classification has been applied to a case of ntPHP.
Domenico Greco,Filippo Maggio 대한당뇨병학회 2015 Diabetes and Metabolism Journal Vol.39 No.2
Background: The association between type 1 diabetes and immunoglobulin A deficiency (IgA-D) has long been recognized in many populations. The aim of this study was to assess the prevalence of IgA-D in patients with type 1 diabetes mellitus all coming from a defined geographical area and to investigate the clinical features of these subjects. Methods: The records of 150 consecutive patients with type 1 diabetes mellitus referred in a period of one year were analyzed. A detailed history was obtained for each patient. Information was collected concerning age, gender, time of onset of diabetes, and presence of other autoimmune diseases. Results: Out of 150 patients with type 1 diabetes, eight (5.3%) had a diagnosis of IgA-D. There were one female and seven male; all these patients were diagnosed by screening: none of them had history of recurrent infections. Autoimmune thyroiditis was coexisting in five patients (62%). Although other associated autoimmune disorders were found in a number of patients, there was no different prevalence rate in IgA deficient patients. Conclusion: This study shows the prevalence of IgA-D in Sicilian patients with type 1 diabetes as 5.3% which is much higher than reported in other Italian studies. Moreover, our data show a high prevalence of IgA-D in male gender and describe thyroiditis as the most frequent autoimmune disease present in these patients. Finally, in our case report, IgA-D diagnosis always followed routine IgA measurement when case finding for celiac disease with no history of recurrent infections in each patient.
Domenico, Dario De,Falsone, Giovanni,Laudani, Rossella Techno-Press 2018 Structural Engineering and Mechanics, An Int'l Jou Vol.67 No.5
Within a probabilistic framework, this paper addresses the determination of the static structural response of beams and frames with partially restrained (semi-rigid) connections. The flexibility of the nodal connections is incorporated via an idealized linear-elastic behavior of the beam constraints through the use of rotational springs, which are here considered uncertain for taking into account the largely scattered results observed in experimental findings. The analysis is conducted via the Probabilistic Transformation Method, by modelling the spring stiffness terms (or equivalently, the fixity factors of the beam) as uniformly distributed random variables. The limit values of the Eurocode 3 fixity factors for steel semi-rigid connections are assumed. The exact probability density function of a few indicators of the structural response is derived and discussed in order to identify to what extent the uncertainty of the beam constraints affects the resulting beam response. Some design considerations arise which point out the paramount importance of probability-based approaches whenever a comprehensive experimental background regarding the stiffness of the beam connection is lacking, for example in steel frames with semi-rigid connections or in precast reinforced concrete framed structures. Indeed, it is demonstrated that resorting to deterministic approaches may lead to misleading (and in some cases non-conservative) outcomes from a design viewpoint.