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Biomedical subjects

G C Canalis

Publications and source records attributed to G C Canalis.

At least 19 recordsLinked to original sources

[Lobular carcinoma in situ: the mammographic aspects and the therapeutic problems].

Lobular carcinoma in situ is an uncommon noninvasive breast neoplasm; it accounts for about 0.8-3.8% of breast cancers and presents 3 peculiar characteristics: multicentricity (60-90%), bilaterality (35-59%), and the risk of invasive cancer (17-37%). The latter feature led some authors to consider this lesion as a marker of the development of an invasive cancer rather than a real malignant neoplasm. The main problem after histologic diagnosis is the choice of treatment: follow-up or surgery? Some authors reported, in the patients with lobular carcinoma in situ, the same incidence of ipsilateral invasive carcinoma as that in the normal population, which suggests a "wait and see" policy. This study, carried out on 27 patients (mean age: 49 years) with histologic diagnosis of lobular carcinoma in situ yielded the following aspecific mammographic findings: clustered microcalcifications; stellate masses and irregular nodular lesions with or without calcifications; architectural distortion with calcifications. In 10 surgical patients, 2 ductal carcinomas were demonstrated near the lobular carcinoma in situ. In the 17 patients submitted to follow-up, lobular carcinoma in situ recurrences were found in 4 patients at biopsy; a comedocarcinoma associated with a metastatic axillary node was found in one patient. Thus, we conclude that, in the patients with lobular carcinoma in situ, a "wait and see" policy of close observation should be adopted.

Adult

[Role of color flow mapping ultrasonography in kidney transplant monitoring].

Color flow mapping and duplex ultrasonography are a more accurate technique in renal allograft monitoring by combining real time us with pulsed doppler studies of renal vasculature. Doppler spectral analysis, pulsatility and resistive index evaluation are usefull in the diagnosis of renal allograft dysfunction (I.E. rejection, cyclosporine nefroto-city and acute tubular necrosis). Cfm and duplex ultrasonography allow a non invasive and easy evaluation of the whole renal artery and vein in the diagnosis of renal artery stenosis, vein trombosys and A-V fistula.

Humans

[Role of color flow mapping ultrasonography in the study of renal tumors].

Tumors cm. 3 in diameter or less have revealed a high frequency of hyperecoic sonographic features mimicking angio-myolipoma. C.T. can confirm the presence of intralesion fat useful to exclude a potentially curable renal cell carcinoma. CFM and duplex ultra sonography can depict a peri and intra lesion neovascularization in small renal cell carcinoma. In the tumor langer than cm. 3 when hyper-vascular CFM and duplex sonography can detect the neovascularized blood vessels surrounding and penetrating the tumors. In the tumor staging the duplex and CFM ultrasonography is useful to demonstrate neoplastic trombosis of renal vein and inferior vena cava.

Humans

[Localization of non-palpable lesions of the breast using a metallic guide. Potential complications].

The authors reviewed the complications occurred in 393 patients who underwent needle localization breast biopsy from September, 1987, through September 1994. The lesions were located using 20-22 G needles with a teminal hook wire. The maneuver was carried out under US guidance in 7 patients, using stereotaxic equipment in 88 patients and without stereotaxic equipment in 298 patients. Clinical and guide-wire related complications were reported. The former complications were: severe vagal crises (in 3 patients), mild vagal crisis (10 patients) and bleeding (1 patient). Guidewire complications were: wire breakage (in 8 patients) and wire dislodgment (3 patients). Vagal crisis occurred above all in anxious patients. Guide-wire breakage or dislodgement may prevent lesion removal and, subsequently, lead to a diagnostic error. Our experiences suggests that information and continuous radiologist attendance positively influence patient's psychology reducing clinical complications. Moreover, operator's experience and care in choosing the appropriate devices greatly reduce the incidence of maneuver-related complications.

Adult

A double-blind comparative study of the safety and efficacy of iomeprol in renal intra-arterial digital subtraction angiography.

This randomised, double-blind, parallel group study was to compare the safety, tolerance and diagnostic efficacy of iomeprol and iopamidol, both at an iodine concentration of 150 mgI/ml, in 40 patients with arterial hypertension who required renal intra-arterial digital subtraction angiography (IA-DSA) for suspected renovascular stenosis. All patients underwent extensive pre- and post-contrast clinical, instrumental and laboratory controls for safety assessments. The tolerance to the test contrast media was evaluated in terms of discomfort associated with the injection of the test compounds. Image quality was prospectively graded by two independent readers according to a five-point scale as follows: 1, insufficient; 2, sufficient; 3, good; 4, excellent; E, excessive. The quality of vascular opacification in the region of interest was rated as diagnostic in 87.8% of radiographs obtained in the iomeprol group and in 84.5% in the iopamidol group, without significant differences between the two study groups. The results of angiography were always useful for subsequent patient management. The procedure was always well tolerated. There were no clinically significant changes in vital signs, ECG and laboratory parameters during the study in both groups. The results of our study show that iomeprol 150 mgI/ml, and iopamidol 150 mgI/ml are equally effective, well tolerated and safe contrast agents when used for IA-DSA.

Adult

[Temporary caval filters. Indications, problems and results].

The authors report their experience with the temporary placement of inferior vena caval filters to prevent pulmonary embolism in acute deep venous thrombosis patients. Twenty devices--6 Filcard and 4 Bruneau type--were positioned and left in situ over a time period ranging 4 to 14 days (mean: 9.8). In one patient the filter was positioned and no adjunctive medical therapy given to provide protection before nephrectomy; five patients were treated with i.v. heparin that provided no vein patency but prevented disease progression. Due to failure in positioning infusion guide catheters within the thrombus, four patients were submitted to fibrinolysis and heparin therapy: when the thrombus stabilized on angiographic images, heparin alone was administered and then followed by orally administered coumarin anticoagulants. In two cases partial thrombosis resolution was achieved, but with no significant improvement in patency rate. Ten patients underwent in situ fibrinolysis: six of them exhibited moderate improvement in femoroiliac axis patency and in three patients the inferior vena cava was successfully recanalized. No patient had any clinical evidence of pulmonary embolism. One case had cranial thrombus spread which was successfully treated with fibrinolysis. In our opinion, to control possible thrombotic involvement of the device, the patients candidate for temporary inferior vena caval filters must be easy to "manage" and exhibit no contraindications fibrinolysis and anticoagulant treatment.

Humans

[Role of phlebography in the study of recurrent leg varices].

In the last four years, 668 phlebographies of the lower limbs were performed in patients affected with varices. Recurrences were detected in 239 patients. Different phlebographic approaches were used, including ascending phlebography of the popliteal and femoral veins and varicography. Specific indications to different techniques are discussed and possible causes of recurrence are analyzed. In patients with recurrent varices, atypical venous drains were often observed, whose involvement could not be detected by either clinical examination or noninvasive instrumental evaluation. Therefore, phlebography represents a reliable and sensitive technique to recognize recurrent varices.

Adult

[Selective arteriography in the study of arterial vasculogenic impotence].

According to the fundamental circulatory nature of penile erection, insufficiency of the arterial blood supply to the corpora cavernosa caused by an organic arterial disease is found in a large fraction of case, overall among the patients aged more than 40. It is possible to evaluate arterial origin of erectile dysfunction by using of noninvasive methods, but to obtain the necessary panoramicity and the characterization of the lesions it needs the use of angiography. Performance of standard arteriography leads to insufficient visualization of pudendal and penile vessels and risks false positive results. Because of penile hemodynamic variability in its different states is necessary the use of pharmacologic devices to perform a diagnostic arteriography. For the selective study of the pudenda and peniena vascularization we perform a selective arteriography bilaterally, with the catheter tip placed in the proximal part of the internal iliac artery. We use a contrast medium particularly diluted and mixed with xylocaine. We perform angiographic sequences after intracavernous injection of 8-10 mgr of papaverine to obtain the maximum blood flow and to prevent spasm of the terminal arterioles. Arteriography gives a complete study of the pudenda arterial tree and its terminal ramifications, and it is able to supply all the necessary informations regarding the planning of revascularization procedures. Treatment of arterial lesions is possible with surgical and radiologic methods. As in other arteries, percutaneous transluminal angioplasty (P.T.A.) can be applied in the therapy of impotence caused by arterial insufficiency. P.T.A. is the election treatment in the stenosis of the common iliac and internal iliac arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography

[The radiological study of afferent and efferent loop syndromes].

The authors report on the diagnostic role of radiological imaging in the study of the patients who underwent gastric surgery. This kind of intervention is often followed by postoperative complications, so that accurate clinical-instrumental investigations are required. Routine controls both in the immediate postoperative period and during follow-up are useful especially when a neoplastic lesion was the underlying condition leading to surgery. Radiological imaging plays a fundamental role especially in evaluating such postoperative conditions as afferent and efferent loop syndromes. Radiology is thought to be essential to demonstrate the syndrome and to identify the mechanical/functional nature of the factors causing the disease, all of which are essential to an appropriate and safe therapy. Both the duration of follow-up (early and late controls) and the choice of contrast (water-soluble contrast medium or double contrast enema) are very important factors depending on the time of surgery and the clinical indication.

Afferent Loop Syndrome

[Transluminal urethroplasty. Preliminary experience in 15 cases].

Thirteen patients with urethral stenoses of different etiopathology underwent TUP with an angioplasty balloon catheter. At follow-up, more than 10 months later, 8 out of 10 patients had normal urinary function. Excluding cases of urethral compression due to prostatic hyperplasia, 90% of the stenoses were successfully dilated. The gradualness of the dilatation, the application of a Foley catheter to maintain the dilatation obtained and the prevention of urinary infections are important factors for the success of this method.

Adult

[Diagnostic and therapeutic value of angiography of the mesenteric area].

The widespread diffusion of digital imaging progressively reduces the indications to conventional angiography in all vascular districts. On the contrary, angiography of mesenteric arteries still works as a valid complementary diagnostic tool in granulomatous and neoplastic lesions of ileum. Today, in selected patients, angiography is the first diagnostic approach to vascular ischemic and hemorrhagic pathology of ileum; timely resort to interventional angiography improve a dramatic prognosis.

Adult

Digital angiography in evaluation of orthopedic tumors.

Preoperative evaluation of orthopedic tumors using digital subtraction angiography (DSA) proved useful to ascertain the nature of the lesion, its extension to soft tissues and joints, and the presence of arteriovenous (AV) shunts. We report that overall accuracy varied from 89% to 92%, depending on the feature evaluated. The importance of angiographic examination of this entity is discussed as well as the advantages of DSA over conventional angiography.

Angiography

[Value of splenic embolization in patients with hypersplenism].

The authors describe the importance of embolization of the splenic artery by means of Gianturco coils in splenomegalic portal hypertension. They propose their first experience of six cases and the good results on the basis of clinical parameters, of bleeding of esophageal varices, of hematological values. They also show the influence of this method on hemodynamic, metabolic, and respiratory parameters, altered in cirrhotic patients.

Adult

[Transluminal esophagoplasty (TE)].

The authors analyze their experience on 9 cases of esophageal stenosis dilated by "Grüntzig" type balloon catheter under fluoroscopic examination (transluminal esophagus plastica: TE). This procedure also allows dilatation of severe narrowing, offering distinct advantages represented by: low risk, easy performance, good tolerance, reduction or disappearance of disphagia. Esophageal perforation is possible, though it never appeared in author's experience.

Barrett Esophagus