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Biomedical subjects

A Giorgio

Publications and source records attributed to A Giorgio.

At least 19 recordsLinked to original sources
PubMed1995

Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with US guidance.

PURPOSE: To determine the efficacy of percutaneous needle aspiration (PNA) with antibiotic therapy in treatment for pyogenic liver abscess (PLA). MATERIALS AND METHODS: One hundred fifteen patients (59 male; 56 female; age range, 16-86 years; mean age, 45.3 years) with 147 PLAs (mean diameter, 6.8 cm; range, 3-16 cm) underwent PNA with ultrasound (US) guidance and antibiotic therapy. Needle caliber (22-16 gauge) was tailored to PLA volume. If necessary, PNA was repeated every 3-7 days. RESULTS: Three hundred one PNAs were performed (range, 1-4 per patient; mean, 2.2 per patient). A single puncture was sufficient in 57 patients. Cure (normalization of clinical and laboratory parameters and resolution of hepatic lesions) was achieved in 113 patients (98.3%). Two patients with large PLAs required surgery. Patients were hospitalized 7-24 days (mean, 9 days). In the last eight patients, all abscesses were evacuated in one session. Neither complications nor deaths ensued. Recurrence of PLA was not observed in any patient during follow-up (6-36 months). CONCLUSION: US-guided PNA with antibiotic therapy in treatment for PLA is a valid alternative to prolonged catheter drainage.

Anti-Bacterial Agents↗
PubMed1995

Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection.

PURPOSE: To define indications for percutaneous ethanol injection (PEI) in patients with hepatocellular carcinoma (HCC) and cirrhosis. MATERIALS AND METHODS: Survival rates were determined in 746 patients who had undergone PEI (567 men, 179 women; mean age, 64.3 years; mean follow-up, 36 months). RESULTS: In patients with Child A (n = 293), B (n = 149), or C (n = 20) cirrhosis and single HCCs 5 cm or smaller, the 3-5 year survival rate was 47%-79%, 29%-63%, and 0%-12%, respectively. In patients with Child A cirrhosis, it was 36%-68% for multiple HCCs (n = 121), 30%-53% for single HCCs larger than 5 cm (n = 28), and 0%-16% for advanced HCC (n = 16). Treatment was associated with a 1.7% rate of severe complications and a 0.1% mortality rate. CONCLUSION: PEI proved safe, effective, and repeatable and had a low cost. Survival after PEI was comparable to that after surgery, probably because of a balancing between greater radicality of surgery and absence of early mortality and liver damage of PEI.

Administration, Cutaneous↗
PubMed1993

Echographic epidemiology of cystic hydatid disease in Italy.

This study was carried out in order to establish the actual prevalence of cystic hydatid disease in Italy using ultrasound. In fact, there is a great difference between the official reports of the disease and epidemiological investigations. From 1988 to 1990, 424 cases of cystic hydatid disease were diagnosed in 333,144 examinations performed in nineteen Italian Echographic Departments, giving a mean incidence of 0.16%. Most of the examined persons arriving at the 19 Echographic Departments had symptoms independent from hydatidosis, were affected with other pathologies, or they were patients attending follow-up for neoplasms. The authors note that human hydatidosis has a high incidence in the south and in the isles; hepatic lesions were 85.61% of all cases of abdominal hydatidosis, asymptomatic cystic hydatid disease was present in 60% of the total number; the average age of the sample examined was 45.38 years without significant differences between men and women. Finally the Authors suggest the importance of echography in planning therapeutic programs.

Echinococcosis↗
PubMed1992

Hepatic abscesses in immunocompromised patients: ultrasonically guided percutaneous drainage.

Ultrasonically guided percutaneous drainage (US-PD) is considered first-line therapy for hepatic abscesses, but no data are available on its efficacy in severely immunocompromised patients. Therefore, we examined 15 such patients in whom one or more hepatic abscesses of different etiology were treated with US-PD. Eleven patients underwent needle aspiration and four had catheter drainage under US guidance. In 12 cases we achieved complete healing of the abscesses. In one case, clinical improvement was obtained but surgery was required for cure. In another case (fungal abscess in AIDS), we had no improvement and the patient died. No procedural complications were observed. Seven patients died during the follow-up periods of up to 49 months from their underlying disease. We conclude that US-PD must be considered the therapy of choice for hepatic abscess (except the fungal lesions) in severely immunocompromised patients.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Unilocular hydatid liver cysts: treatment with US-guided, double percutaneous aspiration and alcohol injection.

Sixteen hydatid liver cysts in 14 patients were treated with a percutaneous double puncture-aspiration-injection (D-PAI) technique with alcohol used as the scolecidal agent. With ultrasound guidance, fine-needle drainage of cysts was performed, and 95% sterile alcohol was injected and left in situ to partly refill the cystic cavities. The same procedure, without reaspiration of the injected alcohol, was performed 3 days later. Viability of scoleces was assessed at each aspiration. Benzoimidazolic drugs were administered 1 week before and 3 weeks after the procedure, to reduce the risk of seeding scoleces. Follow-up ranged from 8 to 28 months (mean, 14 months). Six cysts disappeared within 40-75 days of completion of D-PAI. In the other patients, smaller liquid areas or hypo- or hyperechoic solid masses were observed. Anaphylactoid reactions did not occur. In one patient, a biliary fistula developed after the first aspiration; the second ethanol injection was postponed until 6 months later but was effective. Viable scoleces were found at the second aspiration in only two patients whose hepatic liver cysts completely healed. Serologic titers substantially decreased in seven cases and became negative in two.

Adult↗
PubMed1992

Intravascular circulation and distribution of human 51Cr-DBBF stroma-free hemoglobin.

Male B6C3HF1 mice were infused with 51Cr-labeled DBBF (bis 3,5-dibromosalicyl fumarate) crosslinked stroma-free hemoglobin (SFH). The intravascular halftime (T50) of the DBBF-SFH, determined from plasma hemoglobin levels, was 0.5 hours in the first 10 minutes and 4.3 hours during the next 50 minutes. At 24 hours, less than 5% of the DBBF-SFH remained. Elution of 51Cr was reflected in a lower T50 determined from the radioactivity levels: during the first 10 minutes the T50 was 0.3 hours; in the next 50 minutes it was 1 hour. The radioactivity sequestered in each organ in the first hour following DBBF-SFH infusion was as follows: 11.2% of the infused radioactivity was in the skin, 11.4% in muscle, 9.1% in the skeleton, and 5% in the liver. After 24 hours, the percentages in skin, muscle, skeleton and liver were 15.4, 10.3, 16.6 and 6.7% respectively. The percentage of infused radioactivity in the gastrointestinal tract and kidney at 1 hour and 24 hours ranged from 3.5 to 5.5%. Less than 0.4% was found in the spleen and lung. At 24 hours, 25% of the radioactivity was recovered in urine and 3% in feces.

Animals↗
PubMed1992

Percutaneous ethanol injection under sonographic guidance of hepatocellular carcinoma in compensated and decompensated cirrhotic patients.

Forty-six patients with cirrhosis and 75 biopsy-proved hepatocellular carcinoma (HCC) nodules underwent percutaneous ethanol injection (PEI) regardless of number (up to five) and size (mean diameter, 3.6 cm) of tumoral lesions and clinical severity of cirrhosis (11 patients in Child's class C were included). Ethanol was injected under sonographic guidance through 20 to 22 gauge needles so as to obtain homogeneous hyperechogenicity of lesions. A total of 271 PEI sessions were carried out, delivering 2 to 14 ml per session. All nodules but one decreased in size, and seven were no longer appreciable on sonography. Recurrence was detected in two patients. The 3 year survival rate of all cases was 86%. Child's classes A and B patients fared better (3 yr survival 100%); 2 year survival of subjects with HCC < or = 3 cm was 92%. Multifocality did not affect survival. Most patients experienced mild pain at the site of injection, but only two major complications were encountered: partial chemical thrombosis of the left portal vein and cholangitis. Both cases were managed conservatively. In conclusion, PEI seems to offer a safe and valuable tool for therapy of HCC, especially in patients with good functional liver reserve and small (< or = 3 cm) tumors.

Carcinoma, Hepatocellular↗
PubMed1991

Sonographic recognition of intraparenchymal regenerating nodules using high-frequency transducers in patients with cirrhosis.

In 38 patients with cirrhotic liver, an ultrasound examination was carried out by using 3/3.5-, 5-, and 7.5-MHz transducers sequentially in order to identify hypoechoic intraparenchymal regenerating nodules less than or equal to 20 mm. Twenty healthy subjects and 35 patients with noncirrhotic chronic liver disease were scanned as controls. Focal lesions were disclosed in five patients: one case turned out to be a small hepatocellular carcinoma; regenerating nodules were diagnosed as such in four cases by means of surgery, laparoscopy, and fine needle biopsy. At a follow-up needle biopsy one year later, one of these nodules proved to be malignant. Use of high-frequency transducers offered little aid to the diagnosis of small nodules. In only one case were multiple lesions revealed with a 7.5-MHz probe but not with 3- and 5-MHz probes. It seems that intraparenchymal regenerating nodules are rarely seen with the available technology, and their recognition cannot be recommended as a reliable ultrasound diagnostic marker of liver cirrhosis.

Aged↗
PubMed1991

[Percutaneous therapy of hydatid cyst of the liver with ultrasound-guided double puncture-aspiration and alcoholization].

Fourteen patients (9 females, 5 males; age range: 22-80 years) with 16 univesiculated hydatid cysts of the liver (O ranging 4.2-14 cm) underwent two sessions of puncture-aspiration-alcohol injection (D-PAI) under real-time US guidance at 3-day intervals. Two patients had postoperative recurrences. One patient was pregnant (9 weeks' gestation): her cyst doubled its volume over 2 months. One patient had HBV chronic hepatitis treated by means of interferon: also in this case the cyst doubled its volume. The remaining were high-risk patients for surgery or had refused operation. At US follow-up (ranging 4-24 months) 6 cysts exhibited complete reconstitution of liver parenchyma. In the extant patients two different US patterns were observed: 1) liquid areas with detached inner membranes (4 cysts); 2) solid inhomogeneous areas (6 cysts). In these cases the volume was reduced by 50-80%. No allergic complication occurred either during or after the procedure. Two patients only were affected with vomiting and fever, which resolved in a few hours. Our results indicate D-PAI of univesiculated hydatid cysts of the liver to be an effective alternative to surgery.

Adult↗
PubMed1991

Effect of graft material on loss of erythrocytes after aortic operations.

It has been suggested that loss of erythrocytes after abdominal aortic grafting is influenced by the type of synthetic graft used. A prospective randomized study was done to compare loss of erythrocytes in patients receiving Dacron (polyester fiber, Meadox woven double velour) and Gore-Tex (polytetrafluoroethylene [PTFE]) grafts during the perioperative period. A total of 25 patients (13 Dacron and 12 PTFE) was studied, including 21 with abdominal aortic aneurysms and four with aortoiliac occlusive disease. Erythrocyte volume (EV) was measured using 51Cr-labeled autologous erythrocytes on the day prior to the operation, one to two hours after the operation when the patients were hemodynamically stable and 24 hours postoperatively. In addition to measurements of 51Cr EV and the volume of intraoperatively salvaged washed erythrocytes, the length of storage of the units of homologous liquid preserved erythrocytes at 4 degrees C. prior to transfusion were recorded. The mean intraoperative erythrocyte loss (+/- S.D.) for the Dacron group was 892 +/- 543 milliliters and for the PTFE group, 842 +/- 403 milliliters (p = NS). Patients in the Dacron group received intraoperatively 2.2 +/- 1.6 (units +/- S.D.) milliliters with a range of zero to 4 units of homologous liquid preserved erythrocytes and patients in the PTFE group received 1.2 +/- 1.2 milliliters with a range of zero to 3 units of homologous liquid preserved erythrocytes (p = NS). The mean total loss of erythrocytes (+/- S.D.) was 1,055 +/- 649 milliliters for the Dacron group and 978 +/- 503 milliliters for the PTFE group (p = NS). Despite inherent differences in graft material, there were no significant differences in intraoperative or post-operative loss of erythrocytes or in the number of homologous units of liquid preserved erythrocytes transfused with a p value of less than 0.05 considered significant.

Aged↗
PubMed1990

Decreased in vivo survival of hydrogen peroxide-damaged baboon red blood cells.

In this study we attempt to establish the consequence of in vitro hydrogen peroxide (H2O2)-induced membrane damage as manifested by spectrin-hemoglobin (Sp-Hb) complex formation and decreased red blood cell (RBC) deformability to in vivo RBC survival in baboons. After exposure to 135 to 581 mumols/L H2O2 and reduction with dithiothreitol (DTE), baboon RBCs were infused into the animal, and the fraction of cells remaining in circulation after 24 hours and the lifespan of surviving cells were quantitated. In a dose-dependent fashion, a positive correlation was observed between in vitro membrane alterations and the 24-hour in vivo survival. While 12% of the control cells were removed from circulation in 24 hours, 23% were removed after treatment with 339 mumols/L H2O2, and 36% following exposure to 581 mumols/L H2O2. Pretreatment with carbon monoxide before exposure with H2O2 increased the survival of oxidized RBCs. RBCs not removed from circulation in the first 24 hours had a normal lifespan. Moreover, by selectively isolating biotin-labeled, peroxide-treated cells that survived the first 24-hour posttransfusion period, a significant decrease in Sp-Hb crosslinking was observed in these cells. These results suggest that a subpopulation of cells sensitive to oxidation were removed during the first 24 hours. To identify this population, the survival of density-fractionated RBCs exposed to oxidant stress was quantitated. No differences in either the 24-hour survival or RBC life span were observed between untreated low-density (MCHC less than or equal to 32g/dL) and high-density cells (MCHC greater than or equal to 37g/dL). However, striking differences were noted after treatment with 339 mumols/L H2O2, with the 24-hour survival of high-density cells showing a marked decrease compared with low-density cells. These data support our hypothesis that during peroxidative membrane damage, Hb oxidation initiates a sequence of events resulting in skeletal changes that lead to membrane alterations and, eventually, in vivo destruction, and that the dense, dehydrated cells are more susceptible to oxidant damage.

Animals↗
PubMed1989

Morphologic and motility changes of the gallbladder in response to acute liver injury. A prospective real-time sonographic study in 255 patients with acute viral hepatitis.

In 255 patients with acute viral hepatitis and in 50 healthy controls, wall thickness, volume, and percentage of maximal contraction of the gallbladder were prospectively evaluated using real-time ultrasonography. A hypotonic, hypokinetic gallbladder was shown in 58.4% of the cases, expressed by normal parietal thickness, larger volume, and lower response to fat stimulation than the controls. In the remaining patients, wall thickening, decreased volume, and reduced contraction were compatible with a hypertonic gallbladder. Because the latter pattern was never observed in patients with disease onset dating back more than 9 days, it is conceivable that gallbladder hypertonicity in the early phase of the illness is followed by depression of tone and motor activity. However, such sonographic features turned out to be short-lived and reversible as they disappeared in all patients within 3 weeks of the first ultrasound examination. Moreover, none of the sonographic abnormalities correlated with either biochemical indices of acute disease or the patients' long-term outcomes.

Acute Disease↗
PubMed1989

Detection of microorganisms in clinical specimens using slides prestained with acridine orange (AOS).

Slides prestained with acridine orange (AOS) were used for direct examination of microorganisms in clinical specimens. The method is simpler than a commonly used acridine orange stain (AO) and has the advantage of being a supravital stain. Results indicate that the AOS method is sensitive, and allows rapid detection of microorganisms, even in the specimens containing few microorganisms, e.g. cerebrospinal fluid. Moreover AOS may be the choice method for detection of Trichomonas vaginalis.

Acridine Orange↗
PubMed1989

A simple and rapid method to evaluate lymphocyte response to mitogens.

A new method to evaluate lymphocyte response to mitogens is proposed. The method is based on the observation in fluorescence of the stimulated cells after their supravital staining on slides prestained with acridine orange in alcoholic solution. The results are expressed as Blast Index (IB). The method is very practical, easy to reproduce and shows a good correlation with 3H-thymidine uptake.

Acridine Orange↗