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Biomedical subjects

G Simonetti

Publications and source records attributed to G Simonetti.

At least 163 records · Page 9Linked to original sources

CT of functioning tumors of the pancreas.

Thirty-three patients suspected of having a functioning tumor of the pancreas were studied with computed tomography (CT); 25 had angiographic studies also. Thirty-one cases were confirmed surgically; the other two were lost at follow-up and were excluded from the series. Of the 31 patients, 21 had insulinomas, five had Zollinger-Ellison syndrome, and five had assorted apudomas. CT was positive in 71% of the cases and negative in 29%; 22.6% of the studies were false negative and 6.4% were true negative. There were no false positives. Of the 21 patients with insulinomas, only one had false-negative CT and angiographic studies, caused by diffuse microadenomatosis. In one patient, two separate lesions of the pancreas were seen and identified correctly on both CT and angiography. All identified lesions smaller than 2 cm were seen only because of a hyperdensity on the enhanced CT scan. Lesions larger than 2 cm were identified either because their size distorted the pancreatic contour or because of their vascularity. The importance of proper CT technique using fast scanners and repeated bolus injections of contrast medium is stressed.

Aged↗

[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↗

Hemobilia from ruptured hepatic artery aneurysm: angiographic demonstration of arteriobiliary fistula in a successfully treated case.

Rupture of a hepatic artery aneurysm into the biliary tree is a rare cause of hemobilia. The dramatic nature of the disease and the difficulties in obtaining a preoperative diagnosis are the main causes of its high mortality rate. Progress in vascular radiology and surgery seems to be an important factor in improving the survival rates in patients with this type of hemobilia. A case of a patient with an aneurysm of the common hepatic artery ruptured into the common bile duct is reported. Preoperative arteriography revealed the aneurysm and the arteriobiliary fistula causing massive hemobilia. The patient was successfully treated by arterial ligation and is symptom free after 2 years.

Aneurysm↗

Phase I trial of N-methylformamide.

N-methylformamide was administered iv and later orally to 19 patients in a phase I study, with a starting dose of 300 mg/m2/day X 5. The cycles were planned to be repeated every 2 weeks, and doses were escalated in four steps to 1200 mg/m2/day X 5. The principal toxic effect of the drug was nausea and vomiting, but this was not severe enough to interfere with oral medication. Parallel bioavailability studies confirmed excellent absorption of the drug. Biochemical disturbances included reversible elevation in transaminases not related to dose, peripheral neuropathy in one patient, and drug interaction with alcohol in another. The dose-limiting toxic effect was reversible hyperbilirubinemia. One patient became jaundiced. Among 15 evaluable patients, there were two partial responses (prostate and cervix carcinoma) and two minimal responses (ovarian carcinoma and hypernephroma). The recommended dose for the phase II study is 800 mg/m2/day X 5 orally, repeated every 2 or 3 weeks.

Adult↗

Transcatheter wiring of abdominal aortic aneurysm.

A new technique of transcatheter wiring of unresectable aortic aneurysm is described that provides simultaneous transcatheter occlusion of both common iliac arteries followed by axillofemoral bypass. The spring coil used for aortic aneurysm wiring was of our own making. The outer portion of a movable core stainless steel guidewire was bent in a coil shape and introduced into the aneurysm through a 7 French Teflon catheter via the right femoral artery. The same catheter was also used for coil embolus occlusion of both iliac arteries.

Aorta, Abdominal↗

Digital subtraction angiography for examination of vessels of the leg: use of a 40-cm image intensifier.

Digital subtraction angiography (DSA) using a 41-cm (16-in.) image intensifier was performed in 144 patients with peripheral vascular insufficiency. In most cases the entire peripheral vascular bed from the renal arteries to the popliteal trifurcation was demonstrated with four intravenous injections and four exposed fields: (a) aorto-iliac, (b) ilio-femoral, (c) femoro-popliteal, and (d) popliteo-tibial. In 90% of cases the procedure was diagnostic in all regions studied, while in 10 it was nondiagnostic in one or more regions for various reasons (myocardial insufficiency, inadequate contrast bolus, or technical failure). Most failures involved the distal arteries. In spite of some limitations, intravenous DSA using a large-field image intensifier may replace conventional angiography in routine preoperative evaluation of peripheral vascular disease, with intra-arterial injections being performed when the intravenous technique is nondiagnostic.

Adult↗

[Angioplasty of the renal arteries. Our experience with a 12-month follow-up].

We have treated 56 stenoses of renal arteries in 50 patients in which a renin assay indicated renovascular hypertension. In this paper we refer only to 40 cases of renal arteries angioplasty in 37 patients (3 cases of bilateral stenoses) with a clinical follow-up of 12 months. 25 lesions were of arteriosclerotic nature, while 15 were due to fibromuscular displasia. Results demonstrated that angioplasty resolved hypertensive conditions (either with or without medical therapy) in 82% of the cases of arteriosclerotic lesions and in 86% of the stenoses due to fibromuscular displasia. Although extremely rare, the complications that may occur with this procedure are very serious (arterial rupture, acute thrombosis, peripheral embolization). Out of utmost importance is a close collaboration with a vascular surgeon. Without doubt angioplasty will bring about radical changes in the preparation of therapeutical protocol and in some selected cases to improve renal function.

Adolescent↗