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Biomedical subjects

A Gangi

Publications and source records attributed to A Gangi.

At least 19 recordsLinked to original sources
PubMed2005

Radiofrequency and laser ablation of spinal lesions.

Radiofrequency current and laser energy can be delivered locally through electrode-needle or optical fiber inserted in the tissue and allows local ablation of tissues, up to a volume of 4 to 5 cm in diameter with one application or vaporizes tissue. Tumor ablation guided with medical imaging proved a high local efficacy over 90% for tumors less than 25 mm in the liver, lung, and kidney. The spinal applications of the thermal energy of RF and laser are reported in this paper. First, the tumor ablation is reviewed with malignant and benign tumors. In malignant tumors, radiofrequency is very efficient in local tumor control and in pain management. The second part of this paper is devoted to disk diseases where laser and RF techniques increase their applications. The technique, indications and results of these techniques are reported and illustrated.

Back Pain↗
PubMed2005

Successful treatment of a chronic post-traumatic 5-year-old osteoporotic vertebral compression fracture by percutaneous vertebroplasty.

Osteoporotic vertebral compression fracture (VCF) is a frequently encountered clinical problem associated with chronic pain and disability. Conservative treatment in the form of bed rest, pain control and bracing may create a vicious circle, in which reduced activity leads to further reduction in bone density and fracture risk. Percutaneous vertebroplasty (PVP) is an accepted treatment modality for osteoporotic vertebral body collapse present for less than 1 year, vertebral myeloma, haemangioma, metastasis and recent traumatic fractures (between 3 and 12 months). We describe an osteoporotic patient in whom successful PVP was performed, under general anaesthesia using CT and fluoroscopic guidance, in a post-traumatic 5-year-old VCF with complete alleviation of debilitating pain. In the light of our experience, we suggest that PVP should be carried out in a series of similar patients to asses its value as a treatment option in patients with chronic osteoporotic vertebral fractures for pain relief and improvement in mobility, independent of fracture age.

Back Pain↗
PubMed2004

Percutaneous vertebroplasty: history, technique and current perspectives.

Percutaneous vertebroplasty is a safe and efficacious technique for the treatment of persistent pain from a fractured vertebral body. Injection of cement into the vertebral body is made after insertion of a large-bore needle, frequently by a trans-pedicular approach. Vertebroplasty is most commonly used to treat painful osteoporotic fracture resistant to conservative therapy, but may be helpful in other conditions such as malignant collapse. NICE guidelines are now available for this procedure, which is relatively new in the UK, but has been performed for more than 15 years in continental Europe.

Bone Cements↗
PubMed2003

Fatal bile pulmonary embolism after radiofrequency treatment of a hepatocellular carcinoma.

Radiofrequency is increasingly used to manage liver tumors. This report describes the case of a 74-year-old man who received two courses of percutaneous radiofrequency thermal ablation for a hepatocellular carcinoma over a 4-month period. He subsequently required computed tomography-guided drainage for an area of intrahepatic necrosis. During the procedure, hemobilia developed, followed by respiratory distress and collapse. The diagnosis of bile pulmonary embolism was established on the basis of high biliary acid concentrations in pulmonary fluid aspiration and blood plasma. Radiofrequency thermoablation provides local control of advanced liver tumors with low recurrence and morbidity. However, this interventional procedure risks damage to liver parenchyma involving vascular and biliary structures, which may lead to biliary-venous fistula and possible bile emboli.

Aged↗
PubMed2002

[Symetric lipomatosis of the hands].

INTRODUCTION: We report a case of symmetric lipomatosis in an unusual palmary topography. CASE REPORT: A 56 year-old woman was referred for evaluation of scleroderma. The diagnosis was made 10 years earlier because of acrosclerosis of the distal phalanges of both hands. The disease began 2 months after administration of systemic steroids for severe asthma. Since then, she was followed up for her scleroderma every 2 years without any evidence of systematization of the disease. On examination, the first phalanges appeared protruding and podgy on the palms of both hands. On palpation, the consistence was suggestive of lipomas. Similar nodules were present on the back of both hands at the proximal part of the interdigital spaces. Tomodensitometry confirmed the lipomatous nature of nodules. DISCUSSION: This patient presented with a symmetric lipomatosis of a very unusual distal localization on both hands. This unusual aspect mimicked acrosclerosis. In this case report, chronology suggests that systemic steroids might have induced this lipohypertrophy.

Adrenal Cortex Hormones↗
PubMed2000

Rapid chondrolysis after an intra-articular leak of bone cement in treatment of a benign acetabular subchondral cyst: an unusual complication of percutaneous injection of acrylic cement.

Percutaneous injection of methylmethacrylate is now increasingly employed to treat bone lesions, both malignant and benign. However, the risks of this procedure are still to be fully established. In this report, we describe a case of rapid chondrolysis appearing after the intra-articular leakage of cement during injection of an acetabular subchondral cyst, resulting in hip replacement. Although the mechanism of such chondrolysis is unknown, this event suggests a chondrolytic effect of the acrylic cement. Thus, it is essential to systematically search for the presence of an intra-articular passage before injecting bone cement into a peri-articular cyst. This unusual complication highlights the need for rigorous evaluation of the benefits and risks of percutaneous injection of acrylic cement in the treatment of benign lesions, especially close to an articulation.

Acetabulum↗
PubMed2000

[Diagnostic imaging of the brachial plexus and the cericothoracobrachial outlet].

Imaging of the brachial plexus and of the thoracic outlet syndrome is difficult due to the complex path of the brachial plexus and the morphological variations during the movements. This imaging includes simple radiographs, computed tomographies (CT) and myelo CT scan, magnetic resonance imaging and echo-Doppler. Pathologies of this area include congenital deformities (dysplasia of the upper RIB or of the clavicle), non-malignant or malignant tumors, muscular pathologies, and pathologies of the nerve roots or trunks.

Brachial Plexus↗
PubMed1998

Small leiomyosarcoma of the renal capsule: CT findings.

Three unusual cases of small-size leiomyosarcoma of the perirenal space were studied with CT. The renal capsule has been proved to be the origin of this type of tumor. A CT examination is accurate in suggesting the site of origin and excluding a renal cell carcinoma. However, unless evidence of invasion is noted, it is impossible on CT features to discriminate leiomyosarcoma from a benign leiomyoma.

Adult↗
PubMed1998

Interventional radiology with laser in bone and joint.

Laser energy is able to ablate, coagulate, and vaporize tissues. Its transmissibility in thin optical fibers makes it an ideal tool for use in percutaneous procedures. This article describes two applications in interventional musculoskeletal radiology. In percutaneous laser disc decompression the laser source is used to vaporize a small portion of the nucleus pulposus. In interstitial laser photocoagulation of osteoid osteoma the laser energy is used to coagulate and destroy the tumor by direct heating.

Adolescent↗
PubMed1998

[Treatment of osteoid osteoma using laser photocoagulation. Apropos of 28 cases].

UNLABELLED: THE PURPOSE OF THE STUDY was to evaluate interstitial laser photocoagulation for local destruction of osteoid osteoma, with computed tomographic (CT) guidance. MATERIAL AND METHODS: 28 patients (age range from 5 to 48 years) with presumed osteoid osteoma were treated with CT-guided interstitial laser photocoagulation of the nidus. A high power semiconductor diode laser (805 nm) with a 400 microns optical fiber was used. The fiber was introduced into the nidus through a 18-gauge needle. Around the fiber tip, well-defined coagulative necroses from 5 to 9 mm (energy delivery, 400-1000J) were obtained. RESULTS: 27 patients had complete pain relief, which was effective within 24 hours in 18 patients. One patient had pain recurrence after 6 weeks. The remaining nidus was treated secondarily with complete relief. Treatment was unsuccessful in one patient, and surgical excision was performed. All patients were followed up for more than 1 year, with no sign of recurrence. The only notable complication was a mild reflex sympathetic dystrophy of the wrist in one patient. Sclerosis of the nidus was observed 6-12 months after the procedure. CONCLUSION: Percutaneous interstitial laser photocoagulation of osteoid osteoma seems to be a promising, simple, precise, and minimally invasive alternative to traditional surgical and percutaneous ablations.

Adolescent↗
PubMed1998

[Imaging of non-small-cell pulmonary tumors. Therapeutic strategy].

In this work the imagery of non-small cell primary bronchial cancers are reviewed. The standard chest x-ray of the thorax remains irreplaceable for the early detection of these pathologies. On the other hand, progress in imagery has propelled thoracic computed tomographic scanning to the pole position for assessing the local and regional extension of the disease as well as for distance spread of these cancers. The latest developments with spiral CT have again improved the performance of CT scanning. Magnetic resonance imaging has a few precisely defined roles in assessing the extension of bronchopulmonary cancers. In particular with involvement of the apices, the chest wall and in the extension into the cardiovascular system. In this article the emphasis is on the illustration of non-small cell bronchial cancers on computed tomography and on magnetic resonance imaging.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1997

Interstitial laser photocoagulation of osteoid osteomas with use of CT guidance.

PURPOSE: To evaluate interstitial laser photocoagulation (a minimally invasive percutaneous technique of thermal destruction of deep-seated tumors, with low-power laser energy) in local destruction of osteoid osteoma, with computed tomographic (CT) guidance. MATERIALS AND METHODS: Fifteen patients (age range, 8-48 years) with presumed osteoid osteoma were treated with CT-guided interstitial laser photocoagulation of the nidus. A high-power semiconductor diode laser (805 nm) with a 400-microm optical fiber was used. The fiber was introduced into the nidus through an 18-gauge needle. Around the fiber tip, well-defined coagulative necroses from 5 to 9 mm (energy delivery, 400-1,000 J) were obtained. RESULTS: Fourteen patients had complete pain relief, which was apparent within 24 hours in eight patients. One patient had recurrence of pain after 6 weeks. The remaining nidus was treated a second time, with complete relief. Treatment was unsuccessful in one patient, and surgical excision was performed. Daily activities were not restricted after the intervention. All patients were followed up for more than 1 year, with no sign of recurrence. The only notable complication was a mild reflex sympathetic dystrophy of the wrist in one patient. Sclerosis of the nidus was observed 4-6 months after the procedure. CONCLUSION: Percutaneous interstitial laser photocoagulation of osteoid osteoma seems to be a promising, simple, precise, and minimally invasive alternative to traditional surgical and percutaneous ablations.

Activities of Daily Living↗
PubMed1997

Migratory pulmonary infiltrates in a patient treated with sotalol.

Beta-blockers may induce several types of adverse respiratory reaction such as asthma, interstitial lung disease with or without pleural effusion, systemic lupus erythematosus or hypersensitivity pneumonitis. More recently, bronchiolitis obliterans with organizing pneumonia (BOOP) has been described. We report here on pulmonary migratory infiltrates with combined histopathological features of both BOOP and eosinophilic pneumonia in a woman treated with sotalol long-term. The patient improved only partially with steroids. Tapering off corticosteroid dosage resulted in relapse, and complete recovery was only obtained after sotalol was stopped.

Adrenergic beta-Antagonists↗