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Biomedical subjects

J Galli

Publications and source records attributed to J Galli.

106 records · Page 6Linked to original sources
PubMedDate not supplied

Effect of preoperative radiological treatment of hepatocellular carcinoma before liver transplantation: a retrospective study.

PURPOSE: To assess the results of radiological treatment of patients with hepatocellular carcinoma (HCC) performed before orthotopic liver transplantation (OLT). METHODS: Sixty-two transplanted patients with a total of 89 HCC nodules were studied; 50 lesions in 38 patients had been treated prior to OLT with transcatheter arterial chemoembolization (TACE; n = 29), percutaneous ethanol injection (PEI; n = 10), or combined therapy (TACE + PEI; n = 11). The induced necrosis was pathologically evaluated. The recurrence rate after OLT in the treated group of patients (n = 38) was compared with that in the non-treated group (n = 24). RESULTS: After TACE, necrosis was complete in 7 of 29 lesions (24.1%), partial in 11 of 29 (37.9%), and absent in 11 of 29 (37.9%). After PEI, necrosis was complete in 8 of 10 lesions (80%), and partial in 2 of 10 (20%). Using combined therapy, necrosis was complete in 11 of 11 lesions (100%). Four of 24 untreated and 4 of 38 treated patients did not survive OLT from causes not related to the HCC; 3 of 20 non-treated patients (15%) and 4 of 34 treated patients (11.8%) had post-OLT recurrence (these last four patients had undergone only TACE and did not have tumor necrosis at pathological examination). CONCLUSION: TACE of HCC prior to OLT had no influence on the recurrence rate. PEI and combined therapy (TACE + PEI) may be recommended in patients awaiting OLT.

Adult↗
PubMedDate not supplied

Os odontoideum in a patient with cervical vertigo: a case report.

Cervical vertebral anomalies are often associated with malformations or traumas, they may be completely asymptomatic and represent an occasional finding in vertigo or can cause severe neurologic complications (ie, compression of the upper cervical spine with myelopathy, epilepsy, or respiratory failure). This clinical case is a patient who came to us for observation for a peripheral harmonic vestibular syndrome, and in whom a malformation of the cervical vertebral joint (os odontoideum) was occasionally found on magnetic resonance imaging.

Anti-Inflammatory Agents↗
PubMedDate not supplied

[Carotid body tumors: the clinical, diagnostic and therapeutic aspects].

The authors discuss the epidemiology, histology, symptomatology, diagnosis and therapy of carotid body tumors, basing their discussion on three personal observations and on a case of cervical dermatocyst which showed clinical and radiological data consistent with diagnosis of a glomus tumor. Chemodectomas of the neck are more often seen in the carotid body and are considered histologically benign, although they might induce local or distant metastases. Clinical presentation is often non-specific and may only consist in a slowly growing mass in the higher jugular-carotid region. Among the various imaging techniques (CT, MR), supra-aortic selective angiography, including digital subtraction techniques, is now considered the most reliable tool, while ultrasonography and gammagraphy with 99mTc-gluconate or 131I-MBG are recommended for screening and family testing purposes. Biopsy is to be avoided as it is very likely to cause massive bleeding and because of the high percentage of false negatives. Surgery is the choice treatment, and lateral cervicotomy is the recommended approach for exeresis of the mass, while radiotherapy should be planned in patients with precise contra-indications for surgery and when the tumor mass has already reached the skull base. Pre-operatory selective embolization is still controversial.

Adult↗
PubMedDate not supplied

[Invasive nasosinusal aspergillosis in an immunocompetent patient].

The authors describe a case of invasive nasosinusal aspergillosis in an immunocompetent patient. After a careful bibliographic review, they emphasize that in the present case the diagnosis was made by means of fungal culture as the clinical picture, imaging techniques and histopathological findings were aspecific. The pathogenetic agent resulted Aspergillus tamarii which belongs to the Aspergillus flavus group and is one of the most unusual agents in literature. The treatment of choice, in the invasive form, is surgery that should be as radical as possible followed by a medical therapy. In the present case, after two-phase radical surgery on all the paranasal sinuses, medical treatment with traconazole was employed with excellent local results at a follow-up of one year.

Adult↗
PubMedDate not supplied

[Magnetic fields evoked by auditory stimuli: a normative study].

After outlining the fundamentals of biomagnetism and their possible clinical applications, the authors report the results of a normative study on auditory magnetic fields performed on 18 normally hearing subjects between the ages of 25 and 30. Having presented a thorough review of the literature, they then describe the recording technique employed, the dcSQUID biomagnetic system for signal detection, the shielded room, the characteristics of the stimulus. The auditory magnetic response is characterized by three main waves (P4Om, N100m, P200m) whose latency and amplitude values were calculated. Moreover, in order to localize dipolar activity, certain parameters, such as P and T, were taken into consideration. Localizations were made using a spherical volume conductor or with MRI, which was in any case employed in all the subjects. The waves, especially the N100m recorded contralaterally to the stimulus, showed a reduced latency and an increased amplitude when compared to those recorded ipsilaterally. Moreover, a systematic posterior shift of the N100m source into the left hemisphere with respect to the right one was detected. In conclusion, the authors emphasize the need to study electric as well as magnetic responses in order to better understand auditory cortical functions.

Acoustic Stimulation↗
PubMedDate not supplied

[Ectopic thyroid gland].

Based upon the observation of four cases of ectopic lingual thyroid the authors discuss the etiopathogenetic, clinical-diagnostic and therapeutic aspects of this pathology. The clinical characteristics of the mass, scintigraphy, echography and CT scan of the neck, the T3, T4, TSH doses in the blood and fine needle aspiration of the mass have made adequate appraisal of its possible nature and have led to the identification of the presence of thyroid tissue in other sites. In regard to therapy, the authors believe that surgery is compulsory for patients showing clinical signs of upper airway obstruction despite suppressive therapy or when the lesion shows signs of malignant degeneration. After having mentioned the more commonly employed surgical approaches, emphasis is placed on median pharyngotomy as it permits the best visualization of the region, a careful excision of the mass and a valid control over bleeding. In most cases a tracheotomy proves unnecessary. The post surgical hormonal situation suggests the opportunity of a possible substitutive therapy with synthetic hormones or thyroid derivatives.

Adolescent↗
PubMedDate not supplied

[Double-blind study of the efficacy of an antiserotoninergic drug, pizotifen, in Duchenne's muscular dystrophy].

In 40 patients presenting with Duchenne muscular dystrophy, a double blind therapeutic trial of 18 months was undertaken in order to appreciate the efficacy of pizotifen, an anti-serotoninergic drug. Quarterly evaluations were performed. Each of them included muscular testing on 31 pairs of muscles, timed tests, dynamometric study of the thumb-forefinger grip, functional testing, respiratory function tests, muscular enzyme determinations, parents' subjective estimation and search for side-effects. With respect to the evolution of Duchenne muscular dystrophy, this study did not show significant differences between pizotifen at a dose of 1.5 mg/day and placebo, except for a parents' preference for the drug.

Child↗
PubMedDate not supplied

[Doppler ultrasonography of the intrarenal arteries before and after radiologic treatment in obstructive uropathy].

Resistive index (RI) calculation on Doppler tracing of intrarenal arterial blood flow is a sensitive method for the early diagnosis of obstructive uropathy. However, the RI is not specific and can increase in a number of other conditions, e.g., old age, circulating endogenic factors or drugs, other nephropathies. The authors investigated RI usefulness and accuracy by measuring it both before and after the radiologic treatment of acute urinary obstruction in 21 patients, 9 of whom had chronic renal failure due to other causes, i.e., hypertension, diabetes and chronic pyelonephritis. The clinical conditions of the patients limited the feasibility of RI measurements before and after nephrostomy to 66%. In 22 kidneys in 17 patients examined before nephrostomy, the RI ranged 0.63 to 0.93 (mean: 0.80); when the obstruction was unilateral, the RI was always higher than in the contralateral kidney. In 25 kidneys in 18 patients examined after nephrostomy, the mean RI value was 0.68 (15% lower than before). Taking 0.7 as the cut-off value, RI sensitivity in detecting acute urinary obstruction was high (about 90%), while its specificity was low (about 50%); specificity increased (to about 80%) when other concomitant causes of increased intrarenal arterial resistance, e.g., other vascular or parenchymal nephropathies, were not considered. In some cases, the method was also useful in excluding the presence of recurrent obstruction after ureteral stent removal. In conclusion, Doppler US values of intrarenal arterial perfusion are indicative of acute urinary obstruction when they can be compared with those from the contralateral healthy kidney or when they can be measured, in the same patient, before and after decompressive nephrostomy. In other cases, other nephropathies and some technical limitations must be considered.

Adult↗
PubMedDate not supplied

[Combined craniofacial surgery in malignant tumors of the ethmoid].

The Authors discuss the importance of surgical treatment in ethmoid cancer basing their discussion upon observation of three cases involving the anterior skull base which followed an overview of the epidemiology, histology and evaluation of this kind of pathology. After reviewing Literature they stress the validity of anterior craniofacial resection which allows a wide exposure of the complex anatomic structures at the base of the skull and a monoblock resection of malignant tumors as well as a satisfactory reconstruction of the resulting defect at the skull base. Furthermore, they emphasize the still existing differences among many Authors as far as surgical technique is concerned and the extreme variability of the survival rate. The Authors conclude that in order to make a comparison between the results of different Authors, data concerning the site of origin, the extension and the histology of the tumors and the length of the follow-up should be more homogeneous.

Aged↗
PubMedDate not supplied

[Non-recurrent inferior laryngeal nerve].

The Authors describe a case of non recurrent inferior laryngeal nerve located on the right side observed during anatomical studies of the innervation of the larynx. The description is accompanied by photographic documentation which shows the anomalous course of the nerve and its abnormal relationship with the right subclavian artery, also anomalous. The embryological nature of such anatomical variations is discussed followed by considerations concerning possible consequences with regard to clinical aspects and thyroid surgery. Furthermore, the Authors indicate clinical signs that may suggest the presence of such anomaly so as to avoid anatomical or functional damage of the nerve which, although anomalous, plays an important role in coordinating breathing and phonation.

Humans↗
PubMedDate not supplied

[Hemangiopericytoma of parapharyngeal space].

The parapharyngeal space is a rare site of parapharyngeal neoplasms: their diagnosis and therapeutic treatment offer peculiar challenges. Parapharyngeal tumours may be primary, metastatic or diffused with regaed continuity. They are mostly benign (mixed, neurogenic, vascular tumours, etc.) rather than malignant neoplasms (adenocystic carcinoma, adenocarcinoma, lymphoma, etc.). In order to diagnosis parapharyngeal tumours differentially it is important to consider very rare type of neoplasms such as hemangiopericytomas. In this paper the Authors describe a case of hemangiopericytoma of the parapharyngeal space indicating the main diagnosis procedures, especially CT scan, Magnetic resonance and angiography. They discuss pathological aspects with particular regard to the differential diagnosis between benign and malignant tumour of this kind as well as prognoses. The Authors also describe surgical treatment in relation to particular parapharyngeal localization.

Adult↗