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Biomedical subjects

D Miotto

Publications and source records attributed to D Miotto.

At least 73 records · Page 4Linked to original sources
PubMed1982

Hepatic artery aneurysms.

Four patients with hepatic artery aneurysm are reported. Two patients presented with abdominal pain, initially considered a consequence of pancreatic disease. A third patient had a sudden onset with hemoperitoneum and shock. In the fourth patient the aneurysm burst into the common bile duct causing hemobilia and jaundice. All were successfully treated with hepatic artery ligation, which left the patient free of symptoms during long-term follow-up. Arteriography should facilitate diagnosis and artery ligation appears the best treatment.

Adult↗
PubMed1980

Usefulness of transhepatic portal catheterization in the treatment of insulinomas.

Twenty-four per cent of beta-cell tumours require more than one operation to control the hypoglycaemic syndrome. Almost all of them are small insulinomas undetectable by palpation of the pancreas. Arteriography is too insensitive to detect non-palpable tumours. Transhepatic catheterization of the splenic and portal veins (TPC) can detect the position at which there is an abrupt increase in insulin level indicating the site of the tumour. Routine use of TPC allowed us to locate all 9 insulinomas in which this technique was employed, whereas of 15 patients not studied by TPC only 12 tumours were located at first operation, 2 of which were found by blind resection of the tail of the pancreas. We believe that routine application of TPC to all cases of suspected insulinoma would reduce the incidence of surgical failures, unsuccessful blind resections and lengthy trials of medical therapy before laparotomy.

Adenoma, Islet Cell↗
PubMed1980

The role of vascularization in the formation of echographic patterns of hepatic metastases: microangiographic and echographic study.

An experimental microangiograhic and echographic study was carried out on metastatic autopsy livers which were also examined histologically. Relationships between the echographic pattern and vascularization are explored. In most cases, hypervascular lesions correspond to hyperechogenic patterns, while hypovascular lesions furnish hypoechogenic images.

Angiography↗
PubMed1979

[Anatomy of papilla and intra-renal reflux: microradiographic and histologic investigations (author's transl)].

After a group of autoptic kidneys, taken from new-born babies, had been injected via the ureter with micronised barium at various pressures, they were examined micro-radiographically and histologically in order to observe the appearance of intra-renal reflux and the anatomical structures involved. The radiological patterns, clinically observed during cysto-uretrography, were also considered. The intra-renal reflux is tubular, when injection is carried out at a low pressure, whereas at higher pressures one can observe the erosion of the fornices of the calyces and the following sino-lymphatic and/or venous drainage.

Histological Techniques↗
PubMedDate not supplied

Excess prevalence of supraaortic artery lesions in renovascular hypertension: an arteriographic study.

PURPOSE: High renin or renovascular hypertension (RVH) has been associated with a higher risk of stroke than low-to-normal renin hypertension. Our present purpose was to investigate the angiographic prevalence and distribution of lesions of the supraaortic arteries in a series of consecutive patients with RVH compared with control patients with low-to-normal renin primary hypertension (PH). METHODS: Thirty-two consecutive hypertensives (21 females, 11 males, aged 23-72 years) were investigated by renal and aortic arch digital subtraction arteriography (DSA). None of them had any history or symptoms of cerebrovascular disease. In each, the presence and severity of lesions at 17 different segments of the supraaortic arteries were evaluated and a score for supraaortic lesions was then calculated based on the number and severity of lesions. RVH was diagnosed in 16 patients with renal artery stenoses and normalization of blood pressure after percutaneous transluminal renal angioplasty (PTRA) (n = 12) or surgery (n = 4). The cause of renal artery obstruction was fibrodysplasia in 5 patients (31%) and atherosclerosis in 11 (69%). PH was diagnosed in 16 patients based on a normal renal DSA and exclusion of all other possible causes of hypertension. RESULTS: The RVH and PH groups were similar with respect to age, sex, body mass index, diabetes, smoking habits, serum triglycerides, cholesterol, and blood pressure values, and differed only in plasma renin activity (6.0 +/- 1.7 ng AngI/ml/h in RVH vs. 1.4 +/- 0.3 in PH, mean +/- SEM, p = 0.008). The score for supraaortic arterial lesions was significantly higher in RVH than in PH (181 +/- 32 vs. 17 +/- 9, p = 0.001). This difference was also evident when the five patients with fibrodysplasia were compared with five age- and sex-matched PH patients. The sites most frequently involved were the carotid artery bulb and the internal carotid artery sinus. At each affected site the score was higher for RVH than for PH. CONCLUSION: For the same demographic features and risk profile, RVH was associated with a higher prevalence and severity of supraaortic artery lesions than PH.

Adult↗
PubMedDate not supplied

Giant cavernous hemangiomas: diagnosis and surgical strategies.

From January, 1972 to June, 1989, 51 patients with liver hemangiomas (32 females and 19 males, mean age 35 years) were evaluated for surgical treatment. Diameters of the masses were 5 cm to 20 cm (median 8.5 cm). Nine of the patients had already been treated for cancer. Twenty-two (43.1%) of the 51 patients were symptomatic and 29 (56.9%) patients were asymptomatic. In 34 patients (66.7%) a definite diagnosis of hemangioma was made by scintiscan and/or ultrasound and/or computed tomography and/or angiography while in the remaining 17 (33.3%) patients the diagnosis was uncertain. The most common indications for resection were the presence of a symptomatic angioma, a symptomatic mass with an uncertain diagnosis, and/or lack of a definite pre-operative diagnosis. Surgery was performed on 25 patients. Ten anatomic and 15 atypical resections or enucleations were performed. There were no postoperative deaths. Two further patients, operated for probable hemangioma, were found to have primary hepatic malignancies. In the 26 unresected patients, no complications were observed during follow-up. In 3 patients, hemangioma enlargement was detected by ultrasound, but there were no symptoms. As cavernous liver hemangiomas are now more reliably diagnosed and their natural history is usually uneventful, surgery can be avoided in most cases. However, when a non-resection policy is adopted, an exact diagnosis is essential in order to rule out primary or metastatic cancer. Surgical exploration and treatment should be limited to symptomatic or complicated cases as well as to patients with an uncertain diagnosis.

Adult↗
PubMedDate not supplied

Multislice CT angiography of the celiac and superior mesenteric arteries: comparison with arteriographic findings.

PURPOSE: The aim of the present study is to evaluate the feasibility of multislice computed tomography (MSCT) angiography of the celiac and superior mesenteric arteries with a non tailored protocol. Sixteen patients underwent both MSCT of the upper abdomen and digital subtraction celiac and superior mesenteric angiography. CT examinations included unenhanced scanning and dual-phase (arterial and portal) scanning of the upper abdomen. Retrospective 2.5 mm thick slices with 50% overlap were used for CT angiography reformations with volume rendering (VR), high density maximum intensity projection (HD-MIP) and subvolume MIP technique; normal arterial anatomy, variants, stenoses and aneurysms were assessed and compared with findings of digital subtraction angiography. RESULTS: All VR and HD-MIP reconstructions were considered satisfactory, except in two cases because of inappropriate setting of scan parameters; subvolume MIP reformations were considered satisfactory in all cases, and superior in the depiction of small arteries. Aneurysms and stenoses were always detected, whereas a case of replaced right hepatic artery in a patient with complex vascular anatomy was misdiagnosed by MSCT angiography. The overall accuracy of VR, HD-MIP and MIP CT angiographic reconstructions was 71.9%, 81.8% and 94.6%, respectively. CONCLUSIONS: In our preliminary report, CT angiography with multidetector CT has proved effective in depicting splanchnic arterial anatomy, and can replace diagnostic invasive angiography in most cases. Good quality of axial images is necessary for reformations with VR and MIP techniques.

Adult↗