Biomedical subjects
Publications and source records attributed to A Cavallaro.
Two cases of acute leg ischemia from unilateral occlusion of an aorto-bifemoral graft, treated with high-dose urokinase intra-arterial infusion, are reported. This therapy allowed identification of the cause of thrombosis, recanalization of the graft and planning of reoperation. Indications for intra-arterial thrombolytic therapy and advantages of urokinase vs streptokinase are discussed.
The widespread use of abdominal aortic grafting procedures and increasing awareness of related complications suggests the need for a reliable and non-invasive diagnostic technique which will allow early detection of both occlusive and non-occlusive complications. Ultrasound is generally used with satisfactory results, but has several limitations, whereas MRI has shown great promise in the study of cardiovascular disease, being non-invasive, multiplanar and multiparametric. The present research aims to evaluate MRI in the follow-up of abdominal aortic grafts, attempting to define its significance as a screening procedure in non-selected patients. MRI is reliable in ascertaining the normality of the graft as well as the complications, these being partial or total thrombosis, pseudoaneurysms and perigraft collections. The data obtained are highly satisfactory and are almost always superior to those achieved with ultrasound and CT.
A 15 year experience with 50 popliteal aneurysms in 36 patients is reviewed. Forty-seven popliteal aneurysms were atherosclerotic while three were related to entrapment of the popliteal artery. Fourteen asymptomatic popliteal aneurysms were observed preoperatively during a mean period of 26 months. Ischemic complications developed in five of these. At admission, 16 limbs were asymptomatic (group 1) while the other 34 limbs presented with ischemic symptoms (group 2). No operation was performed upon three limbs, and another two were surgically explored and amputated. No operative deaths resulted from 45 vascular reconstructions. Results from follow-up study of one to 176 months (a mean of 57 months) revealed a late patency rate of 62 per cent. The late patency rate of autologous saphenous vein (ASV) was 100 per cent; polytetrafluoroethylene (PTFE) and Dacron (polyester fiber) grafts had a patency rate of 74 and 34 per cent, respectively (ASV versus PTFE, p = N.S.; ASV versus Dacron, p less than 0.002). The rate of late salvage of limbs was 88 per cent. The bypass grafts of group 1 and those performed upon limbs with good runoff fared significantly better than others (p less than 0.05 and p less than 0.001). The risk of natural complications of popliteal aneurysms and the good results from surgical treatment suggested that a revascularization procedure in the asymptomatic stage is always recommended. The use of PTFE grafts for repair of popliteal aneurysms is justified when the ASV is not available. The use of Dacron grafts is no longer indicated.
The authors present their experience with abdominal aortic aneurysm during the last 12 years. From 1976 up to now they treated 70 patients with abdominal aortic aneurysms. Sixty-seven patients (96%) were male, while 3 (4%) female. Mean age was 65 years (S.D. +/- 7.97). 82% of the patients were heavy smokers. Sixty-five patients were treated by means of resection and vascular reconstruction. Their associated pathologies were: M.I. or severe heart ischemia 34 (52.3%), diabetes 13 (20%), hypertension 25 (38.4%), T.I.A. 6 (9.2%), renal insufficiency 13 (20%), and respiratory insufficiency 18 (27.6%). Results demonstrated a 12-year patency rate of 91.8%. Five high-risk patients were treated by means of "palliative" treatment. Associated pathologies and risk factors were: smoking 5 (100%), M.I. or severe heart ischemia 5 (100%), diabetes 2 (40%), hypertension 4 (80%), T.I.A. 2 (40%), renal insufficiency 2 (40%), respiratory insufficiency 3 (60%). Treatment consisted in the sac thrombosis by means of Gianturco-Wallace coils into the aneurysm (2 cases) and iliac artery ligation (3 cases). Both techniques allowed acute thrombosis of the aneurysm. Vascular supply to the lower limbs was performed by means of an axillo-bifemoral reconstruction in all cases. Long-term prognosis of these five patients was poor due to their general condition.
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The influence of knee flexion on the hemodynamics of ten Below Knee (B.K.) femoro-popliteal by-passes (mean follow-up 45 mos. min. 2-max. 134) has been studied by means of Doppler Pressure Index (P.I.) and Pulse Volume Recorder (P.V.R.). In all patients operative indication was limb salvage and the graft material was autologous saphenous vein (ASV) in 5 cases, PTFE in 3 and Dacron in 2. Calf and ankle P.I. and P.V.R. wave amplitude modifications have been evaluated bilaterally just after the beginning of knee flexion (80 degrees) and at 10 and 15 minute intervals. The knee flexion influenced detrimentally (p less than 0.025) the P.I. (calf: -10.9% at the beginning, -17.8% at 10 min. and -20.5% at 15 min.; ankle: -7.4% at the beginning, -13.6% at 10 min. and -16.5% at 15 min.). P.I. was minimally affected by knee flexion in non-grafted limbs (-3%). No consistent P.V.R. modifications were observed.
Introduced in 1957, atrazine is a herbicide used worldwide, mainly in corn cultivation areas for weed control. It is only slightly volatile, is highly soluble in water, and is moderately persistent in topsoil, where it is strongly absorbed to organic carbon. Because of these properties, atrazine can leach to ground water and persist for a long time. This work presents the results obtained so far from an investigation initiated because of an emergency situation in the Lombardia Region of Italy caused by the occurrence of levels of atrazine in drinking water exceeding those established by the European Economic Community and Italian regulations. Water samples from almost 3000 wells were analyzed in different laboratories of the Lombardia Region. Atrazine contamination occurred in a significant number of the wells examined. Examination of the analytical data overall leads to the conclusion that the agricultural use of atrazine in the Lombardia Region is a serious source of ground water contamination. In some areas other factors may be responsible for the contamination of ground water (for instance, industrial activities and/or uncontrolled waste discharges). Geological and hydrological characteristics may play an important role in ground water contamination. Purification systems containing active charcoal seem to be highly efficient in removing atrazine from contaminated water.
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The therapeutic activity of 5-FU in large bowel cancer is enhanced by increasing the intracellular pool of reduced folates. We treated 45 patients with advanced colon cancer with HDFA and 5-FU for 5 consecutive days. None had been given previous radio- or chemotherapy. All had measurable disease. Not one complete response was observed. Thirteen of the 39 evaluable patients showed partial response. Median duration of response was 9+ months. The probability of 50% survival was 15 months for all evaluable patients. There was no case of severe toxicity and the principal toxic effects were oral mucositis and diarrhea. To date, HDFA + 5-FU is one of the most effective treatments for large bowel cancer.
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Explore the source record for details and available documents.
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The term Raynaud's phenomenon is the eponym of a clinical picture culminating into and dominated by accessorial vasomotor crysis which are triggered by different stimuli (cold, cigarette smoking, emotional stress); cold sensitivity however, is a rather constant feature. Little is known about peripheral nerve involvement in Raynaud's phenomenon but for cases secondary to thoracic outlet syndrome or to primary neurologic diseases, systemic or not. The aim of the present work was to evaluate non-invasively the involvement of arterial flow as well as of nerve function in subjects complaining of Raynaud's phenomenon.
Inosine pranobex-BAN injected intraperitoneally at a daily dose of 500 mg/kg for 15 days into young Sprague-Dawley rats, beginning 24 hours after the implantation of Yoshida ascites tumor cells and the injection of cell-free ascites fluid from the same neoplasia, increased the resistance to the tumor in both cases. This antitumor activity of the drug was mediated by its action on cellular immunity of the host. In our model we considered the role of macrophages.
The authors report the preliminary results of a prospective study on intra-arterial chemotherapy and radiotherapy of advanced cervix carcinoma. The drugs were delivered by a totally implanted Infusaid Model 400 pump and patients received cyclic therapy consisting of Cis-Platinum, Methotrexate and Bleomycin. The catheter tips were positioned during a laparotomy in the hypogastric arteries with sutures and the pump was implanted in a subcutaneous pouch in the abdomen. After chemotherapy all patients had radiotherapy. Five patients entered in the study. Preliminary results suggest that long-term intra-arterial infusion chemotherapy for the treatment of advanced cervix carcinoma is practical for many patients. Two of five patients, after intra-arterial chemotherapy and radiotherapy, had radical hysterectomy.
The current noninvasive techniques for investigating the response to epidural spinal cord stimulation in peripheral arterial occlusive disease patients are far from optimal. Transcutaneous oxygen tension measurements in these patients treated with spinal cord stimulation demonstrated a statistically significant increase during the stimulation and 30 min after the pacemaker has been switched off, suggesting the effectiveness of the spinal cord stimulation on cutaneous oxygenation. The transcutaneous oxygen tension measurements would represent in the future a reliable parameter to predict the effect and to modulate the pacemaker setting in peripheral arterial occlusive disease patients.