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F Cesarani

Publications and source records attributed to F Cesarani.

At least 19 recordsLinked to original sources
PubMed1999

Sonographic appearance of aggressive angiomyxoma of the bladder.

Aggressive angiomyxoma is a rare, benign but locally aggressive mesenchymal neoplasm. We report the sonographic findings in a case of histologically proven aggressive angiomyxoma of the bladder. Sonography revealed a solid polypoid mass 2 cm in diameter with sharply demarcated borders, a heterogeneous echotexture, and a slightly hyperechoic rim.

Adult↗
PubMed1999

[Vascular calcification after kidney transplantation. Preliminary results].

BACKGROUND: Vascular calcifications (VC) are a common feature in chronic dialysis patients, but their clinical significance is debated, and the role of kidney transplantation (TRP) in the natural history of their development has received only scanty attention. METHODS: In our study we reviewed skeletal surveys as well as clinical and biochemical records of 13 patients who started again chronic dialysis at our Centre after failure of their kidney grafts. Changes of VC (during TRP) were scored as: 1 = no substantial progression (4 patients), 2 = moderate worsening (4 patients), 3 = severe worsening (5 patients = 38.4%). RESULTS: The most interesting association with the clinical/biochemical parameters seems to be between the score 3 subgroup and highest Ca*P values and vitamin D therapy. Four out of five score 3 patients experienced overt vascular events and 4 out of 5 of the same subgroup experienced parathyroidectomy (PTX) before, during or after the TRP. CONCLUSIONS: In this preliminary study we can conclude that a) the possibility of dramatic worsening of VC during TRP is not a rare event and this feature has a strong clinical implication, b) PTX before TRP could remove at least one of the putative risk factors in patients waiting for TRP with suboptimal control with medical therapy.

Adolescent↗
PubMed1999

[Tridimensional ultrasonography. First clinical experience with dedicated devices and review of the literature].

PURPOSE: We report our preliminary clinical experience with three-dimensional ultrasound (3D US) in abdominal and small parts imaging, comparing the yield of 3D versus 2D US and through a literature review. MATERIAL AND METHODS: We used a Tomtec Echo-Scan 3.1 connected to a Philips P 700 unit with a 3.5 MHz convex probe and to a Toshiba SSA-340 A (equipped with power Doppler) with a 3.5 MHz convex and a 7.5 MHz linear probes. The system consists of: a) a workstation (166 MHz Intel Pentium, 128 Mbytes RAM, 520 Mbytes hard disk, 1.3 Gbyte Magneto-Optical drive); b) a spatial location system (3D Freehand Scanning) whose sensor, attached to the probe, provides spatial coordinates for each US scan in an electromagnetic field created by a transmitter; the software can thus correctly stack 2D US images to make 3D reconstructions of anatomical structures. The technical steps are: 1) setting; 2) image acquisition; 3) image processing and 3D rendering using surface or volume modes; 4) image archiving. 2D US was performed on 50 subjects, namely 20 volunteers and 30 patients with different pathologic conditions and 3D reconstructions were obtained from the best US images. We evaluated which anatomical structures and pathologic conditions are best suited for 3D rendering. RESULTS: The best 3D images were obtained from anatomical structures and pathologic conditions with a liquid content (i.e., bladder and gallbladder; cysts), or those adjacent to them (i.e., uterus and prostate). Major limitations were encountered in the assessment of the parenchyma of liver, kidneys, pancreas, thyroid, testis and breast, due to intrinsic texture low contrast, while intraparenchymal liquid structures (i.e., vessels, urinary cavities) and structures surrounded by liquid (i.e., hydrocele, ascites) were better demonstrated. DISCUSSION: The system permits accurate spatial location, and therefore stacking, of each US scan; this provides good-quality 3D images with fewer artifacts. The system can be connected to any existing US unit and to many kinds of probes. Incorrect processing or rendering may worsen 3D image quality and thus anatomical reconstructions; other drawbacks may come from difficult stacking of reconstructed images or limited field of view. Our personal experience and the review of 3D US literature indicate that the system may be used for the following clinical applications: anatomical assessment of lesions for minimally invasive treatment; targeting areas of interest and adjacent structures during radiotherapy; lesion volume studies during therapy; 3D vascular mapping with power Doppler; 3D reconstructions by intraluminal approach; real-time 3D scanning for US guidance during minimally invasive procedures. CONCLUSIONS: Our preliminary experience suggests that technological progress will soon lead to a widespread use of 3D US and its applications.

Humans↗
PubMed1996

Morphological comparison of mitral and aortic bioprostheses explanted from the same patient for primary tissue failure.

Host factors might influence the fate of tissue prostheses. We have analyzed the tissue failure phenomenon in mitral and aortic porcine bioprostheses explanted from the same patient so as to avoid the bias of host factors. The 50 bioprostheses of this study were explanted from 25 patients reoperated on because of malfunctioning due to primary tissue failure. Bioprostheses explanted were photographed, radiographed and observed in polarizing light. All lesions analyzed received a score on the basis of morphological criteria. No difference was observed in the occurrence of pannus, tears or cells infiltrates. Calcifications occurred more extensively in mitral position (p=0.0031). Creep of the stent was significantly greater in mitral position (p=0.0324). Since the model of our study removed other individual factors, we may conclude that there is evidence for an earlier and more extensive calcific degeneration in the mitral than in the aortic position.

Aortic Valve↗
PubMed1994

[The reliability of echotomographic diagnosis in assessing thyroid lesions. A comparison with cytology and histology].

The authors report their personal experience in 160 patients affected with thyroid conditions examined with US and fine needle aspiration (FNA). Benign nodular hyperplasia, cystic-colloid nodular hyperplasia, colloid cyst, hemorrhagic cyst, adenoma, thyroiditis, follicular and malignant lesions were studied. The latter consisted of 5 papillary carcinomas, 6 follicular carcinomas, 1 medullary carcinoma, 1 Hürthle cell carcinoma, 1 lymphoma and 1 metastatic lesion. The following US patterns were observed: 69.2% of the malignant lesions were hypoechoic, 15.4% were hyperechoic and 7.7% isoechoic. Most of the malignant lesions (84.6%) had inhomogeneous echo texture; 46.1% of them exhibited peripheral microcalcifications. US diagnoses were compared with cytologic and/or histologic findings to assess US accuracy. In the surgical patients US accuracy reached 78.6% in benign lesions and 61.5% in malignant lesions. Since US alone fails to yield enough pieces of information for an accurate diagnosis to be made, especially when malignant lesions are concerned, FNA should be used, while trying to define the actual role of color-Doppler US.

Adolescent↗
PubMed1990

[The results of the percutaneous treatment of obstructed ureteral diversions. The technic and personal experience in 46 cases].

The ureteral diversions performed in the treatment of mainly malignant lesions of the pelvis with ureteral or bladder involvement may be complicated by strictures and cause hydronephrosis, pyelonephritis and lithiasis. Personal experience and technique are described as applied in the percutaneous antegrade drainage of different urinary diversions (cutaneous ureterostomy, ileal conduit, colon conduit, ureterosigmoidostomy, ureterocolostomy) in 46 patients. The good results obtained (70% success rate), the absence of major complications, the low cost and the little patient discomfort confirm the leading role of percutaneous treatment versus surgery in obstructed urinary diversions.

Aged↗
PubMed1988

Percutaneous transhepatic cholangioscopy with a 2.8 mm fiberscope.

The authors describe their initial experience with a 2.8 mm (8.5F) fiberscope. The instrument, used to refine interventional radiology maneuvers of the intra- and extra-hepatic bile ducts, caused no additional discomfort to the 18 patients treated. The fiberscope permitted differentiation between different causes of biliary stenosis in the few cases where doubt persisted after percutaneous cholangiography. Brushing was also performed wherever necessary. The color, and thus the composition, of bile duct stones could also be determined. This has helped us to plan the therapy with methyl-tert-butyl-ether (MTBE) in patients with cholesterol stones. Compared with traditional fiberscopes (diameter of 5mm or more) the new instrument is easier to use, and allows more peripheral ducts to be reached, but is expensive and has a smaller field of view and fewer possibilities for therapeutic applications.

Bile Duct Diseases↗
PubMed1988

[Use of an electrohydraulic lithotripter in the percutaneous treatment of biliary tract calculi. The preliminary clinical experience in 4 cases].

The results are reported of percutaneous transhepatic treatment with an electrohydraulic lithotripter in 4 cases of bile duct lithiasis. An electric discharge, generated by a bipolar electrode, gives origin to high-amplitude and low-frequency shock waves in the fluid medium which cause the stone to fragment. Complete resolution of lithiasis was obtained in 2 patients with intrahepatic calculosis. In the other 2 cases of massive lithiasis of intra and extrahepatic bile ducts the treatment, however incomplete, proved to be useful, as the biliary flux was rehabilitated and clinical symptoms disappeared. No relevant immediate side-effects were observed, except for well-tolerated pain during the discharges, and transitory hemobilia which solved spontaneously. No complications were observed in this series of patients. Electrohydraulic lithotripsy proves thus to be useful for supporting standard interventional radiology techniques in very complex cases of intra- and extrahepatic bile duct stones.

Aged↗
PubMed1988

[Use of a high-frequency pulsed hydro jet in the percutaneous treatment of biliary tract calculi].

A new system (Broxo Jet) is described for bile duct washing to complete mechanical maneuvers during nonsurgical treatment of intra- and extrahepatic calculi. The device is connected either to a percutaneous biliary drainage catheter or to a fibroscope, and provides a high-frequency pulsating water jet. Seven patients with intra- and extrahepatic bile duct stones were treated with this new technique. Complete resolution was observed in 4/7 cases. The water jet allows the mobilization of even the biggest stones and the elimination of stone debris, as well as the removing of fibrin and necrotic tissue fragments tightly attached to bile duct walls in subacute cholangitis.

Adult↗
PubMed1988

[X-ray computed tomography in latero-cervical lymph nodes, clinically undetectable, in preoperative staging of malignant neoplasms of the larynx].

Postoperative CT of the latero-cervical lymph nodes was carried out in 25 patients suffering from laryngeal cancer. The surgically removed lymph nodes themselves were measured and examined histologically. 529/621 removed lymph nodes (about 85%) were recognisable with CT. The metastasized lymph nodes were clearly identified because of the presence of hypodense, poorly vascularised central foci. Some lymph nodes with a diameter of more than 15 mm on CT investigation proved free from metastatic lesions. This criterion should therefore be considered inadequate for diagnostic purposes. The CT cannot be held to be sufficiently precise to avoid conservative functional latero-cervical emptying as it is probably not able to recognise metastases without capsular rupture, not present in this series.

Adult↗