[Transition from theory to practice: problems and prospects].
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Biomedical subjects
Publications and source records attributed to D Casolino.
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An integrated system for the multimedia management of images and clinical information has been developed at the Isituto Nazionale Neurologico C. Besta in Milan. The Institute physicians have the daily need of consulting images coming from various modalities. The high volume of archived material and the need of retrieving and displaying new and past images and clinical information has motivated the development of a Picture Archiving and Communication System (PACS) for the automatic management of images and clinical data, related not only to the Radiology Department, but also to the Radiotherapy Department for 3D virtual simulation, to remote teleconsulting, and in the following to all the wards, ambulatories and labs.
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The small X-ray beam profiles produced by linear accelerators and used in stereotactic radiosurgery were studied. Circular focusing and not-focusing beams outlined by additional collimators (diameter ranging 10 to 30 mm) and square field outlined by the jaws (field size 10 to 30 mm) were measured. 6 and 18-MV X-ray beams from a dual energy accelerator and 6 and 15-MV X-ray beams produced by 2 single-energy accelerators were used. Measurements were carried out with Kodak X Omat V films in a perspex phantom in the same conditions for all the fields. To study the profile characteristics we introduced the V80/V20 = (R80/R20)3 ratio where R80 and R20 are respectively the mean distance of the 80% and 20% isodose lines from the beams axis. Measurement results show that 6-MV X-ray beams have a higher V80/V20 ratio than the ones obtained with the other energies. There is no significant difference between the beams produced with focused collimators and those produced with not-focused collimators. Square fields outlined by the jaws have a V80/V20 ratio greatly dependent on the accelerator used. This ratio is generally worse than the ones obtained with beams outlined by additional collimators.
Carcinoid tumour of the larynx is extremely rare. The increasing number of these lesions reported is due to the application of ultrastructural and immunological methods in the diagnosis. Two new cases of this malignant neoplasm are presented and discussed with particular reference to the difficulty in distinguishing carcinoids from other tumours of the larynx. The accurate pathological identification of the tumour is essential for treatment and prognosis.
Besides the more frequent aspects, an unusual manifestation of renal osteodystrophy occurred in a 19-year-old man on regular hemodialysis treatment. About 6 years after the start of hemodialysis, the patient, who had severe osteodystrophy, presented a brown tumor, localized to the jaw, which caused a serious deformity of the face. Pharmacological treatment for hyperparathyroidism did not reduce the volume of the mass. Only total surgical removal gave long-lasting success. Brown tumor is an unusual but serious complication of renal bone disease which can be treated successfully by surgical removal of the tumoral mass and by pharmacological treatment for hyperparathyroidism.
In patients undergoing radiotherapy (RT) for malignant neoplasies of the head and neck the availability of a diagnostic method permitting frequent, easy checkups of the latero-cervical lymph nodes would be extremely useful. This is especially so because clinical examination is often hindered by the post-actinic fibrosis of the tissues. Among the methods presently available for this purpose (CAT, NMR, lymphoscintigraphy, xerography, ultrasound) echotomography appears to be the most indicated as it is least invasive, can easily be repeated and is not difficult to perform. The refining of ultrasound techniques would, as reported in the literature, make it possible today to evaluate the effects of RT on latero-cervical metastases both during and some time after treatment. The authors, therefore evaluated the advantages and limitations of the method examining 33 patients undergoing RT for latero-cervical metastases due to head and neck carcinoma. Each patient underwent ultrasound examination prior to, during and at the end of the RT treatment cycle. Once treatment had been terminated 18 underwent latero-cervical neck dissection. Upon termination of the radiation treatment three distinct types of ultrasound behaviour were identified: complete response; partial response; minimal or negligible response. For those patients undergoing surgery this response was compared to lymph node chain histology while, for the others, it was compared to the ultrasound findings of subsequent examinations. The results obtained appear to indicate that a systematic scheduling of ultrasound checkups offers a reliable evaluation of how metastatic adenopathies respond to RT. At times such response can only be completed several months after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
A surgical graphic console is presented. It allows the display of multimodal images (CT, MR and digital angiography), and the identification of tridimensional outlines of structures of surgical relevance, within a surgical reference system, together with the trajectory of surgical approach.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.