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Biomedical subjects

E Ceglia

Publications and source records attributed to E Ceglia.

35 records · Page 2Linked to original sources
PubMed1984

[Radiotherapy of local recurrences of surgically treated rectal and rectosigmoidal cancer].

Local surgical failures of rectal and rectosigmoidal cancer are often observed and represent a heavy clinical problem from the viewpoint of quality of life. After having referred bad results of radiotherapy in a group of 55 patients locally relapsed after radical surgery, the authors analyse causes of therapeutic failure, underlining that ineffectiveness of radiation treatment comes mainly from late and, frequently, not complete diagnosis. Computed tomography must be currently considered the best way for monitoring these patients in order to get an earlier detection and the most correct radiation treatment plan.

Humans↗
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↗
PubMed1982

[Echography and percutaneous fine needle biopsy].

Echography, even if it is a procedure widely used in numerous protocols, is not devoid of diagnostic inaccuracy. However, when fine needle percutaneous biopsy is associated to echography, the diagnostic accuracy raises to 88%. This combined procedure is easily carried out, it is inexpensive, without discomfort to the patient and devoid of major complications. When it is performed, other more invasive techniques, such as arteriography or laparotomy may be useless. Methods of application and case-reports are illustrated.

Adenocarcinoma↗
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↗
PubMed1981

[Fine needle biopsy with ultrasound guidance: 263 cases (author's transl)].

The combination between ecography and fine needle aspiration biopsy has greatly speeded up diagnostic procedures. Often this technique is better than other more invasive and expensive investigations, such as angiography and laparotomy, for its high diagnostic accuracy, the limited upsetting of the patient, the absence of serious complications and the simplicity to perform it. Here are some information on the technique, on the indications and on the complications of the procedure. The results of 263 cases of abdominal biopsy are presented.

Abdominal Neoplasms↗
PubMed1980

Pancreatic tumor imaging by III generation CT, gray-scale ultrasound and improved angiography.

Thanks to computed tomography (CT) and gray-scale ultrasounds the possibilities of morphological diagnosis in pancreatic disease have improved. Nevertheless, only a part of the potential performances of this practice is known and especially for ultrasounds, where only an expert eye can properly read the resulting images. With the help of pictures we hereby deal with the above-mentioned procedures in the demonstration of a pancreatic neoplasm. The possible integration with other more invasive methods was verified compared to pancreatic angiography. The latter is irreplaceable in the presurgical stage, and the method proposed by the authors can be useful when other methods cannot be employed.

Angiography↗
PubMed1980

Arteriography in childhood tumours.

Percutaneous arteriography was used as the investigation of choice in 121 children with clinically suspected malignancy on 132 occasions. Major complications occurred in 2% of the investigations and misdiagnosis in 10%. The arteriographic information was complementary to that of other, routine, investigations in 18% (25 investigations) but in 70% it was crucial, either ruling out a malignancy or defining its nature, site and size while also serving as a guide for biopsy, surgical manipulation, radiotherapy and/or chemotherapy. Arteriography can shorten the work-up in childhood tumours, especially those of the abdomen, eliminating the need for less informative radiological investigations. However, the complications encountered confirmed the peculiar difficulties and risks of paediatric arteriography and the need for strict case selection and a high degree of skill.

Adolescent↗
PubMed1980

Improving arteriography of the pancreas.

Simple celiac and mesenteric arteriography in the prone position with the injection of a large bolus of contrast medium, as fast as possible, is evaluated on the available data against the more complex usual procedure for diagnosing diseases of the pancreas. The new procedure, based upon a better distribution of the contrast medium because of its density, can well simplify angiography of the pancreas without a loss of information.

Angiography↗
PubMedDate not supplied

Magnetic resonance imaging in the initial staging of Hodgkin's disease and non-Hodgkin lymphoma.

Seventy-four consecutive previously untreated patients with Hodgkin's disease (HD) and non-Hodgkin lymphomas (NHL) were evaluated with chest, abdominal and pelvic magnetic resonance (MRI) for initial staging. All patients underwent routine radiological staging procedures which included chest radiographs and lymphography (LAG). These studies were followed in most of cases by laparoscopy, during which biopsies of the liver and the spleen were taken, and bone marrow aspiration and histology. A correlation of the results of MRI with both other imaging studies and histopathologic diagnoses was performed, and discordant cases were assessed to determine the impact on clinical staging. Additional evidence of disease involvement was provided mainly in the chest, where MRI demonstrated the presence of unsuspected disease in 21% of involved patients (9 of 42). Retroperitoneal lymph nodes were correctly assessed in 97% of cases if MRI was compared with LAG. Extranodal abdominal disease was identified both in the spleen (14%) and in the liver (1%). Bone marrow abnormalities were detected in 19% of patients (14 of 74). MRI findings influenced the staging of HD and NHL patients in 11 of 74 cases (15%).

Abdomen↗
PubMedDate not supplied

Subclavian venous thrombosis due to indwelling catheters: a prospective study on 52 patients.

Clinical occurrence of subclavian venous thrombosis due to indwelling catheters is rare, but there is some evidence that subclinical thrombosis frequently occurs. It is purpose of this study to report the results of a prospective investigation in patients with subclavian vein catheters. Fifty-two patients admitted to the Istituto Nazionale Tumori of Milan and candidate to infraclavicular percutaneous catheterization of the subclavian vein were evaluated. There were 26 polyvinyl chloride and 26 rubber silicone catheters, which were correctly positioned in the superior vena cava-atrium. Average duration of the intravenous stay was 12.8 days. Asymptomatic thrombosis was venographically demonstrated in 46.1% of the polyvinyl chloride catheters and in 11.5% of the silicone ones (p = 0.005). The average age of catheters with or without thrombosis was 10.8 and 13.8 days, respectively. Addition of heparin to the infusate (1 U/ml) did not reduce the thrombosis rate in polyvinyl chloride or in silicone catheters, but risk of thrombosis was significantly higher (p = 0.03) in polyvinyl chloride catheters without heparin in comparison to the silicone ones. Osmolarity of the infusional fluid, manipulation during the cannulation, colonization of the catheter tip, and duration of the intravenous stay of the catheter apparently did not influence the rate of thrombosis. Since the natural history of the thrombotic subclavian veins is not known, some caution must be paid to repeat the percutaneous cannulation of the same vein and the change the catheter over a guidewire.

Adult↗
PubMedDate not supplied

Locally advanced breast cancer treated with primary chemotherapy: comparison between magnetic resonance imaging and pathologic evaluation of residual disease.

AIMS AND BACKGROUND: We evaluated the response of locally advanced breast cancer to induction chemotherapy using MRI techniques. The size and vitality of any residual pathologic tissue was quantified by means of morphologic and dynamic analysis. A curve derived from the dynamic parameters shows the uptake intensity with respect to the time elapsed since administration, which is related to vascularization and therefore indirectly reflects the angiogenesis of malignant tissue. METHODS AND STUDY DESIGN: A group of 30 patients were examined with MRI for staging purposes before undergoing treatment and subsequently to assess the response to treatment. Alterations in size and dynamic parameters were closely monitored. RESULTS: The overall accuracy was 90%, the sensitivity 96%, the specificity 75%, the positive predictive value 92.5% and the negative predictive value 66%. Interestingly, analysis of the dynamic curves made it possible to obtain additional information regarding the angiogenetic activity of the residual tumor. CONCLUSIONS: Evaluation of the response to treatment by means of conventional imaging and clinical examination can be particularly difficult because of the fibrosis induced by cytotoxic drugs or the small volume of residual disease. The additional information supplied by MRI could therefore allow a more conservative surgical approach in selected cases of optimal response to treatment, as well as a much more accurate follow-up. Furthermore, the variation in dynamic parameters according to the vitality of residual disease could in the future become a useful tool for monitoring the effectiveness of anti-angiogenetic drugs.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Magnetic resonance in neoplasms of the adipose, fibrous and muscular tissues].

Two-hundred and three MR examinations were reviewed of 177 patients with lipomatous, fibrous and muscular tissues tumors which were evaluated at staging or during the follow-up. All examinations were obtained with a 1.5T superconductive magnet, and both T1 and T2-weighted images were acquired. Its high-contrast resolution, its direct multiplanarity and its allowing both T1 and T2-weighted images to be obtained, are the most important characteristics of MR imaging. In our experience, MRI demonstrated a high overall accuracy (96.1%)-95.2% at restaging alone--with similar sensitivity both at the staging of the disease (100%) and during the follow-up (97%). Overall sensibility was 97.6%. MR specificity in histologically proven relapses was 87.9%. Even though it is gradually assessing itself as the most important method in the evaluation of soft tissues masses, MRI allows an histological diagnosis to be made only in lipomatous tumors and in benign fibrous tumors, due to their specific signal features. The commonest though aspecific finding is a soft tissue mass with relatively low signal intensity in T1 and high signal intensity in T2-weighted images. In our opinion, MR imaging is the method of choice during the follow-up of the disease, whereas it is probably a complementary technique in the staging.

Adipose Tissue↗
PubMedDate not supplied

[Somatic sequelae induced by radiotherapy in bone segments in adults].

The authors, on the basis of reports found in literature and of a personal series, discuss the radiological aspects, the differential diagnosis, the main factors that lead to bone sequelae, and the possible contributory causes and complications. The radiological aspects is characterized by the association of sclerotic and atrophic changes, with a prevalence of the latter in the involvement of the mandible and the cranial bones. Among the main factors there are the radiation dose and its chronological distribution. In fact, the higher the values of the nominal standard dose (NSD), the higher the incidence of such alterations and the more difficult to carry out the efficacy of their treatment. These alterations are found almost exclusively after treatment with administration, in terms of NSD, of more than 1352 rets. Among the contributory causes there are all the factors that may change the physiological condition of the bony tissue. The most common complications are fractures and septic osteitis, the last particularly frequent in the mandible. These alterations and mainly fractures may be solved even spontaneously, even if rather late, so that conservative treatments are indicated. After osteitis it is usually possible to avoid pseudoarthrosis. In cases irradiated with higher doses, osteotomy is often necessary sometime followed by poor results.

Femur↗
PubMedDate not supplied

[Radiographic semeiotics of bone metastasis in thyroid carcinoma].

It's well-known that thyroid malignant cancer often metastatizes to skeletal structures. Analysing a wide casuistry of the National Cancer Institute of Milan, we thought right not only consider most common iconographic findings of these bone metastases, but rarest too. Therefore, we studied many radiological symptoms: osteolysis and its shape; extension in the next soft tissues; absence of the periosteal reaction; some resemblances with other primitive cancer or secondary too and dysplasic focus; the changes after therapy usually give a not univocal interpretation of the pictures regarding these peculiar alterations.

Bone Neoplasms↗