The clinical case presented is one of common iliac artery aneurysm, provoking a radicular compression symptomatology from L4 to S1. It is stressed that neurologic disorders having a radicular content are extremely rare in aorta-iliac vascular compressive pathology. In the case described, the involvement of several nerve roots is attributed to the aneurysm's unusual size (like a fetus' head) of the aneurysmatic sac.

Aged↗

PubMedDate not supplied

[Prenatal diagnosis of hemoglobinopathies in the 1st and 2nd pregnancy trimesters].

Fetal diagnosis of haemoglobinopathies, mainly thalassaemia, is widely used for the prevention of these diseases. Since 1975 fetal diagnosis has been carried out in the second trimester of pregnancy (18th - 22th week) on fetal blood samples obtained by fetoscopy or placentocentesis. The biochemical technique most commonly employed has been represented by carboxymethylcellulose chromatography and more recently in our center by isoelectric focusing of haemoglobins which is a faster and cheaper technique. First-trimester fetal diagnosis is now feasible by DNA analysis on chorionic villi. The Milan center experience in second trimester fetal diagnosis of haemoglobinopathies on more than 300 cases and the preliminary data on first trimester diagnosis are reported.

Blood Specimen Collection↗

PubMedDate not supplied

[Cell cultures from vertebrate tissues].

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Animals↗

PubMedDate not supplied

[Blood levels of lead in printers and policemen in the city of Rome].

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Adolescent↗

PubMedDate not supplied

Use of topical nonsteroidal anti-inflammatory drugs after photorefractive keratectomy.

BACKGROUND: Photorefractive keratectomy (PRK) requires a careful pharmacologic regimen during the postoperative period to reduce corneal haze and refractive myopic regression. Noncorticosteroidal anti-inflammatory drugs limit postablative corneal inflammation without the complications that may occur during corticosteroid treatment. METHODS: Twenty consecutive eyes of 10 patients with attempted correction ranging from 4.00 to 9.00 D of myopia were studied. During the postoperative period, corticosteroid drops (dexamethasone 0.1%) were instilled in the first eye of each patient, and the second eye was treated with diclofenac sodium ophthalmic solution 0.1% (Voltaren). Follow-up was 12 months after surgery. RESULTS: Corneal haze and refraction were studied. Six of the 10 eyes treated with noncorticosteroidal anti-inflammatory drugs did not show any significant difference in corneal haze and refractive evolution compared to the contralateral eyes treated with corticosteroids. Two eyes (20%) showed less corneal haze and more refractive stability than the contralateral eyes. In two eyes (20%), we observed similar corneal haze but more refractive regression than in the contralateral eyes. CONCLUSIONS: Eyes treated with topical diclofenac sodium had a similar postoperative course as those treated with corticosteroids, but without the adverse effects of corticosteroids. Topical nonsteroidal anti-inflammatory drugs are represented by diclofenac (Voltaren), which has significant ocular penetration. This permits reduction of the possibility of general and ocular complications that frequently occur with corticosteroids. The aim of this study was to evaluate the efficacy of topical nonsteroidal antiinflammatory drugs vs. corticosteroidal eyedrops after photorefractive keratectomy (PRK) to reduce moderate and high myopia.

Administration, Topical↗

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[Severe pulmonary gas embolism caused by intraoperative administration of hydrogen peroxide].

We report the case of a 3 year old boy who developed cardiac arrest during general anesthesia, immediately after the subcutaneous administration of hydrogen peroxide solution. Massive pulmonary embolization was hypothesized as the postoperative ECG showed an acute heart strain. However the occurrence of transient anisocoria, associated with a paresis affecting the left arm, remained unexplained. Since brain MR did not reveal any pathological data, a direct toxicity of hydrogen peroxide on a limited area of the CNS could be assumed.

Child, Preschool↗

PubMedDate not supplied

Myopic keratomileusis with the excimer laser: one-year follow up.

BACKGROUND: The possibility of using an argon fluoride excimer laser to perform the refractive incision in keratomileusis spurred us to develop the present surgical technique of using a microkeratome to make a primary corneal incision that yields a corneal disc, then making the refractive excision of stroma with excimer laser ablation, and finally suturing the corneal disc in place. METHODS: We describe the procedures and a prospective study of 30 consecutive eyes from 22 consecutive patients with high myopia (range, -11.20 D to -24.50 D) who underwent excimer laser myopic keratomileusis. A plano corneal disc was cut with a BKS 1000 microkeratome, followed by argon fluoride excimer laser ablation of the stroma with the Summit Eximed UV 200LA laser (Summit Technology, Inc, Waltham, Mass), either of the resected disc (28 eyes) or in situ on the stromal bed (two eyes). RESULTS: By 3 weeks after surgery, 83% of the corneas were considered clear. In 17 eyes (57%), the difference between the intended and achieved refraction was < 1.00 D; in 9 eyes (30%), the difference was 1.00 to 3.00 D; in 4 eyes (13%), the difference was 3.00 to 6.00 D. At 12 months after surgery, uncorrected visual acuity was 20/40 or better in 3 (10%) eyes, and 20/50 to 20/100 in the remaining 27 (90%) eyes, in contrast to 100% of eyes that saw worse than 20/200 before surgery. Two eyes had a very deep ablation of the lenticule that led to irregularities in Bowman's layer. CONCLUSIONS: Excimer laser myopic keratomileusis is an effective way to correct high myopia and may be more accurate than other methods of keratomileusis. A new nomogram for the procedure is presented.

Adolescent↗

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Keratomileusis for myopia with the excimer laser (Buratto technique): short-term results.

We present a prospective clinical study based on the results of 150 consecutive cases of myopic intrastromal keratomileusis cases using the Exci-Med UV200 193 nm excimer laser 193-nanometer (Summit Technology, Inc, Waltham, Mass) to reduce high myopia. The mean and standard deviation of the follow up considered was 3.13 +/- 1.12. The mean preoperative spheroequivalent was -18.96 +/- 3.70 D and -2.32 +/- 2.36 D postoperatively. One hundred twenty-eight eyes (85.3%) were within +/- 1.00 D from the intended correction. In a majority of cases the best spectacle corrected visual acuity was unchanged or improved. No cases of intraoperative complications were observed; postoperative complications are reported. The Buratto technique to correct or reduce high myopia is efficient and safe, while the predictability is satisfactory.

Adolescent↗

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Photorefractive keratectomy for myopia from 6.00 D to 10.00 D.

Surgical correction of mild and high myopia using excimer laser photorefractive keratectomy (PRK) remains controversial. We present a retrospective study of 40 consecutive PRK procedures performed to reduce myopia ranging from -6.00 D to -10.00 D. Postoperative follow up was 24 months. The mean preoperative spheroequivalent refraction was -8.12 +/- 1.52 D; postoperatively it was -2.31 +/- 1.25 D. In 26 of 40 eyes (65%) we observed a regression of the refraction effect after 6 months. In 85% of eyes a persistent corneal haze (+1 grading) was observed at the end of follow up. Photorefractive keratectomy to correct or reduce mild or high myopia is simple and safe but had poor predictability and significant refractive regression in this series.

Adolescent↗

PubMedDate not supplied

Continuous non chronomodulated infusion of floxuridine in metastatic renal cell carcinoma (MRCC): report of 17 cases.

AIMS AND BACKGROUND: MRCC responds poorly to usual treatments. Recently floxuridine (FUDR) has been administered by chronomodulated infusion, obtaining interesting results. In order to simplify the infusion, we used continuous non chronomodulated infusion. METHODS: We treated 17 patients affected by MRCC with continuous non chronomodulated infusion of FUDR. Toxicity was evaluated according to WHO criteria. Responses were recorded as complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). RESULTS: Sixty-four courses of therapy were administered; 15/17 patients, treated with a median of 4 cycles, were evaluable for the response. Only 1 patient showed a grade 3 toxicity (mucositis and diarrhoea); 6 patients showed grade 1-2 diarrhoea; 2 grade 1-2 nausea and vomiting; 1 grade 2 anaemia and thrombocytopenia. No patient obtained CR; 2 PR (lasting 7 and 9 months respectively) and 4 SD (lasting 4,5,6 and 9 months) were observed. CONCLUSIONS: In our experience continuous non chronomodulated infusion of FUDR did not show important general toxicity. The observed responses were not good enough. We think that a better selection of patients (good performance status) and the use of FUDR in an earlier stage of disease, can obtain better results.

Adult↗

PubMedDate not supplied

Laparoscopic sonography: a real alternative to cholangiography during laparoscopic cholecystectomy?

BACKGROUND/AIMS: The routine use of intraoperative cholangiography (CGP) during laparoscopic cholecystectomy (LC) is still under debate. Previous reports suggest that intraoperative sonography can replace CGP in the evaluation of common duct lithiasis during open cholecystectomy. The present study was performed to evaluate the possible role of sonography during LC. PATIENTS AND METHODS: 45 patients were submitted to laparoscopic sonography of biliary tree during LC. In all cases, CGP was performed. RESULTS: In 37 cases, sonography did not show the presence of stones; in 7 cases, common bile duct stones were identified by sonography; one false negative was observed. A sensitivity of 87.5%, a specificity of 100% and an overall accuracy of 97.8% were obtained. A false positive was obtained with CGP with a sensitivity of 100%, a specificity 97.3%, and an overall accuracy of 97.8%. CONCLUSIONS: Laparoscopic sonography can represent an adequate substitute for CGP as a screening procedure during LC.

Adult↗