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Biomedical subjects

B Damascelli

Publications and source records attributed to B Damascelli.

At least 19 recordsLinked to original sources
PubMed1992

Embolization and chemoembolization for hepatocellular carcinoma.

A check on the rationale for embolization and chemoembolization for hepatocellular carcinoma and a revisit to the background of the anatomy of blood supply to the liver is discussed. The technique of the embolization is different and mostly in the range of home made configuration. There is no data concerning the stability of different choices such as the popular mixture of cytotoxic agents and lipiodol. Therefore the authors have preferred the use of microencapsulated Mitomycin believing that this special formulation of the drug can attain the present best reproducibility. The survival of 32 treated patients was longer than the control group. Twelve, 36 and 60 month survival was 70%, 45% and 15% vs 37%, 0%, and 0% respectively.

Capsules↗
PubMed1992

[Combined use of real-time digital subtraction radioscopy and computerized tomography: potential advantages in diagnostic and interventional radiology].

The idea of combining fluoroscopy and CT arose from the daily practice in diagnostic and interventional radiology. A Diasonics OEC high-performance image intensifier complete with a digital subtraction system was connected to a Siemens Somatom-DRH CT scanner to work in tandem. CT is used for a localization in-depth and fluoroscopy for the subsequent maneuvers within an organ or body compartment. With this combination, complex procedures such as transarterial portography, percutaneous embolizations, pain treatment and manipulation for catheterization of the bile ducts and urinary tract could be performed in one place and in one session. CTF is especially useful when patients should not be moved about from room to room or undergo an examination in several sessions, as it happens with children or critically ill or contagious patients.

Adult↗
PubMed1991

Flexibility and efficacy of automatic continuous fluorodeoxyuridine infusion in metastases from a renal cell carcinoma.

Complete and lasting control of diffuse metastases from a renal cell carcinoma has been achieved by automatic continuous infusion of a single cytotoxic agent, fluorodeoxyuridine (FUDR). A patient with a single brain metastasis from renal cell carcinoma developed pulmonary, mediastinal, and retroperitoneal metastases after radical nephrectomy. A Medtronic Synchromed pump (Medtronic Inc., Minneapolis, MN) was implanted for the circadian systemic infusion of FUDR in 14-day courses with 14-day drug-free intervals. A complete response (CR) at all sites, was obtained in 3 months, and maintained for 22 months. After a second brain metastasis, treated by radiation therapy and cisplatin as radiosensitizer, a CR was obtained again and is now of 31 months' duration, which is four times the record to date. The overall hospitalization was 2 days. Acceptance of the pump is excellent and it functions precisely and reliably. This case should stimulate greater interest in techniques of automatic continuous infusion of cytostatics, given its greater efficacy and lower toxicity.

Brain Neoplasms↗
PubMed1990

Hepatic arterial embolization with microencapsulated mitomycin C for unresectable hepatocellular carcinoma in cirrhosis.

From 1986 to 1988, 35 patients with a hepatoma judged either inoperable or unresectable because of coexistent cirrhosis were treated with hepatic arterial embolization of mitomycin C microcapsules. Five of these 35 patients (14.5%) could not be treated because of inability to selectively cannulate the hepatic artery and were therefore excluded from the evaluation (feasibility rate, 86%). There were 24 men and six women with a median age of 57 years (range, 47 to 79) who could be classified as Okuda I (14 pts) or Okuda II (16 pts) and Child Class A:18 and Child Class B:12 in the remaining patients. A median dose of 0.5 mg mitomycin C/kg was administered to each subject and the treatment was repeated at 5 to 6 week intervals. Seventy courses were administered to these 30 patients (median, two courses/patient; range, 1 to 4). Minor complications were frequent (63%) but always either resolved spontaneously or after appropriate medical treatment. Neither severe renal nor hepatic toxicity was observed. No specific treatment related mortality was observed. When alpha-fetoprotein levels and tumor volume were assessed to evaluate the response to treatment using established criteria for identifying a response, an objective response was found in 43% of the cases treated. The actuarial median survival was 7 months and the 1-year actuarial survival was 36% (51% for those rated as Child Class A and 0% for those identified as Child Class B, P = 0.04 and 78% rated as Okuda Types I and 0% Okuda type II, P = 0.0001). The excellent quality of life and the increased survival rate experienced after mitomycin C microcapsule embolization suggest that this treatment modality can be used successfully in patients seen in the West who have unresectable hepatoma.

Aged↗
PubMed1990

Circadian continuous chemotherapy of renal cell carcinoma with an implantable, programmable infusion pump.

The authors treated 42 metastatic renal cell carcinoma (RCC) patients who had received no previous chemotherapy or radiation therapy with circadian venous continuous infusion of 5-fluoro-2-deoxyuridine (FUDR). The drug was delivered by Medtronic Synchromed implantable pump (Medtronic, Inc., Minneapolis, MN) in 14-day cycles alternating with 14-day intervals of heparinized physiologic saline infusion. In the course of 24 months 444 cycles of therapy have been given for a total of 12449 days of pump function. Of the patients observed for at least 3 months (range, 3 to 23 months; median, 7 months) three showed complete response (7%; 95% confidence interval, 0% to 15%), three partial response (7%; confidence interval, 0% to 15%), 18 stable disease, and 18 showed progression. Eighteen patients, all with advanced disease at the time of implantation, were living 6 months after treatment started. Circadian continuous central venous infusion of FUDR is minimally toxic. The FUDR can be delivered safely and conveniently in this way for long spans. This therapy is as active as any currently available treatment, is administered in an entirely outpatient setting, and is associated with a normal quality of life.

Adult↗
PubMed1988

[Magnetic resonance of the thoracic aorta].

Various pathological conditions of the thoracic aorta were studied by MR Imaging in 31 patients: 23 were aneurysms (branching and non-branching), 2 arterio-venous fistulae, 2 aortic prostheses, 2 Marfan's syndromes, 1 coronary sinus aneurysm, and 1 isthmic stenosis. MRI studies were always performed on patients who had been examined by other imaging procedures. A comparative study was carried out on the results of MRI, angiography, computerized tomography, and ultrasounds. The possibility of propedeutic protocol was explored. Our experience, in accordance with the literature on the subject, indicates MRI as the procedure of choice in the study of aneurysms of the thoracic aorta. The advantages offered by MRI--the high natural contrast between circulating blood and the supporting structures, the possibility of obtaining multiplanar images as well as data on intraluminal, parietal, and extraparietal conditions--make it a highly competitive procedure if compared to either CT or angiography. While awaiting further evidence, the use of a propedeutic protocol in non-aneurysmatic diseases is still not advisable, due to insufficient patient population, and to the lack of a consistent literature on the subject.

Adult↗
PubMed1986

Interventional radiology with venous port (chemotherapy and infusional support).

A completely portable permanent central venous access, consisting of a steel capsule sealed with a silicone membrane and connected to a silicone catheter (Port-a-Cath), was implanted in the subcutaneous tissue of 36 patients, most of whom no longer had accessible peripheral veins and needed to continue chemotherapy or undergo total parenteral nutrition. The access vessel was mostly the subclavian vein and the capsule was sutured to the pectoral fascia. Total subcutaneous implantation seems to afford optimum safety from infection and freedom for personal hygiene, produced no noteworthy complications and proved relatively simple to maintain.

Adolescent↗
PubMed1986

[Cardiac magnetic resonance with electronic axial angulation].

MR usually provides sections in three standard orthogonal plans (axial, sagittal, coronal). In the present research we have studied the possibilities and the benefit of the anatomical images performed along the main cardiac axis, using--beyond the cardiac gating--a particular software which allows to obtain layers with a double angulation, still keeping the patient supine. This provides a more detailed visualization of the cardiac architecture and a good evaluation of its functional conditions.

Evaluation Studies as Topic↗
PubMed1984

Massive lymphorrhoea after fine needle biopsy of the cystic haemolymphangioma of the liver.

Trauma to a hepatic haemangioma from a fine needle biopsy has not yet been reported and the theoretical high risk with 22-23 g needles in patients with this lesion tends to be minimised. Through misdiagnosis biopsy was ordered in one case of cystic haemolymphangioma of the liver in a patient being checked by ultrasonography for possible metastases. Aspiration was complicated by a massive peritoneal lymphorrhoea, which regressed completely in 15 days. The mechanics of the event and its possible effect on the pre-existing liver failure, held to be the direct cause of death three months later, is a matter of hypothesis.

Adult↗
PubMed1982

Combined modes of imaging for liver hemangioma in cancer patients.

Twenty-nine consecutive patients with single or multiple liver hemangioma were assessed with more than one mode of imaging. Static scanning with 99Tcm was done in 21, ultrasonography in 28, CT in 29 and angiography in 27. Fine-needle percutaneous biopsy was unwisely performed in 7 cases with a single but singular complication, severe peritoneal lymphorrhea. Four laparotomies and 2 laparoscopies completed the investigations. Fourteen patients had a history of primary cancer, and 3 of these had a secondary coexisting with the angioma. CT was characteristic; ultrasonography was sensitive and perhaps specific enough for small angiomas. The 2 combined plus angio-CT greatly reduce the need for hepatic angiography.

Angiography↗
PubMed1981

Exploiting gravity in abdominal angiography.

The difference between the specific gravity of blood and contrast medium and the consequent tendency of contrast media to fill the lower tissues is exploited in abdominal angiography by special positioning of patients: prone for the coeliac, hepatic and mesenteric arteries, prone with the legs raised for abdominal aortography; lateral decubitus on the side of interest for renal angiography. The advantages are better parenchymal opacification, increased contrast and improved details. Gravity positioning saves time and material, and is easy to learn.

Angiography↗
PubMed1975

Angiography of retroperitoneal tumors. A review.

Abdominal aortography and selective angiography of the branches, large and small, of the abdominal aorta were used systematically to establish the diagnosis in 45 consecutive cases of primary retroperitoneal tumor. No angiographic features peculiar to tumor types were elicited, probably because of the great variety of histologic material encountered. Angiography, nonetheless, proved most helpful for the surgical approach, whether radical removal or an exploratory operation with biopsy was contemplated. In 80 per cent of cases the tumor margins were demarcated, the details of the blood supply defined, and the nature, benign or malignant, correctly diagnosed.

Adolescent↗