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Biomedical subjects

G Juliani

Publications and source records attributed to G Juliani.

At least 19 recordsLinked to original sources
PubMed1992

[Percutaneous transjugular intrahepatic portosystemic shunt (TIPS). The preliminary experience and proposal of a new method].

A new interventional procedure employing metallic stents has been recently suggested to perform percutaneous portosystemic shunts in the treatment of variceal bleeding in portal hypertension; the technique is called TIPSS (transjugular intrahepatic portosystemic stent shunt). This percutaneous treatment presents several advantages over surgery: the shunt diameter can be calibrated according to the degree of portal hypertension; moreover, TIPSS can be performed in patients waiting for liver transplantation because it does not alter the vascular anatomy of liver. The original technique employed transhepatic portography. In this paper the authors report on their personal experience and present their series of 4 patients with portal hypertension and variceal bleeding, in whom TIPSS was performed utilizing noninvasive US guidance. Variceal bleeding was successfully treated in all patients and variceal distension was also obtained.

Adult↗
PubMed1989

[Accuracy of CT in the demonstration of lymph node metastasis in pulmonary carcinoma].

The CT, surgical and histological findings were examined of 350 lymph nodes in a perspective study of 50 patients affected with lung cancer. CT accuracy could thus be evaluated in assessing the size of hilar and mediastinal lymph nodes; the incidence of histologically-proven metastases in nodes more/less than 10 cm in diameter could also be determined, together with CT diagnostic accuracy for nodal metastases. Finally, CT capabilities were also evaluated in distinguishing N0 from N1-N2 patients. CT proved to have high negative predictive value and low positive predictive value, which caused the authors to raise the normal threshold value of CT evaluation of the greatest diameter for hilo-mediastinal nodes from 10 to 20 mm.

Humans↗
PubMed1988

[Percutaneous needle biopsy of the lung. Critical review of 496 cases].

Between February 1979 and December 1986, 618 lung biopsies were performed on 496 patients (122 with double puncture, using Tru-cut and 19-20 G needles). Overall diagnostic accuracy was 84.5%; the 77 patients examined in the past 18 months only underwent thin needle (19-20 G) biopsies--which were carried out by an experienced radiologist--and more sophisticated cyto-histological techniques were employed. Such a procedure gave better results (sensitivity 94.1%, accuracy 94.8%) than did the use of larger caliber needles in the past years; moreover, no complications occurred in these patients. In conclusion, 19-20 G needles are to be preferred to bigger ones, provided that the operator be experienced and cyto-histology be correctly performed.

Adolescent↗
PubMed1988

[MR tomography in adrenal pathology. Preliminary report on 25 histologically controlled cases].

Twenty-five patients affected by adrenal glands pathology underwent CT and MRI: 6 non-functioning adenomas, 2 Cushing's adenomas, 2 Conn's adenomas, 6 metastases, 3 cysts, 2 carcinomas (Cushing's syndrome), 1 lymphoma and 3 pheochromocytomas. Diagnosis was subsequently confirmed either at surgery, or autopsy, or with needle biopsy. In all cases normal adrenal glands and pathological lesions were showed by MRI. T1 signal intensity and mass diameter were compared with T2 signal intensity, represented by the intensity ratio between the adrenal mass vs normal hepatic parenchyma. MRI signal intensity, usually high in case of malignancy and low in adenomas, shows a mean value which is much wider than that referred to mass diameter evaluation (carcinoma is larger than adenoma); for this reason those findings have proved to be insufficiently accurate for adrenal tissue characterization, even for the evaluation of cysts and pheochromocytomas. In the same cases CT showed higher accuracy.

Adenoma↗
PubMed1986

[Interventional radiology in non-neoplastic diseases of the biliary tract. A report on 93 personal cases].

Most references in the literature on interventional radiology of the biliary tract refer to the treatment of cancer; only occasionally are benign conditions mentioned. An updated list of useful radiosurgical instruments on the market in Italy is presented. The operating technique from the preparation of the patient to the performance of percutaneous transhepatic cholangiography (PTC), biliary drainage, transhepatic bilioplasty, percutaneous extraction and chemical cholelitholisis of biliary calculi and drainage of biliary collections is then described. A personal series is then presented. It consists of 93 patients in whom one or more of the following conditions were diagnosed: exclusively intrahepatic calculosis (3 cases), calculosis of the common bile duct (23 percutaneous treatments), empyema of the gallbladder (6 cases), suppurating cholangitis (46 cases), sclerotic or inflammatory stenosis (16 cases), biliary collections (14 cases). Results are reported and commented on.

Adult↗
PubMed1985

[Cholecystography and ultrasound compared in the radiological diagnosis of chronic cholecystitis].

In 50 patients awaiting cholecystectomy, both cholecystography and cholecystosonography have been performed (or repeated), in order to examine the gallbladder wall implementing both examinations with the cholecystokinetic test. The results, related to the surgical, anatomical- and histo-pathological reports, show that, to detect gallbladder parietal lesions, the two studies are complementary in the diagnosis of cholecystitis: consequently, in the authors' opinion, they should always be carried out in association, with the exception of cases when cholecystography may not be possible either because of radiation protection reasons or because of jaundice. Although further experiments are required, it is suggested that the cholecystokinetic test be revalued.

Adult↗
PubMed1985

[Transcutaneous chemical cholelitholysis with methyl tert-butyl ether (MTBE). lst results in man].

Three patients have been treated, with instillation of MTBE through a transcutaneous biliary drainage after transduodenal sphincterotomy. The first had gallbladder stones, the second common bile duct stones and the last intrahepatic stones (V segment). While in the first case there has been only a partial success in the other two we have obtained a total dissolution of the stones, with complete clinical recovery. This treatment has not caused immediate side effects but the absence of long term damage has not yet been proven. We think that the use of MTBE is not indicated in gallbladder stone disease. Its major indication is the dissolution of ductal gallstones when transduodenal sphincterotomy and endoscopic removal of the stones have failed.

Adult↗
PubMed1979

[Correlations between splenoportographic findings and risk of digestive hemorrhage in portal hypertension].

In 102 cases examined by splenoportography (93 cirrhosis with patent splenoportal axis and 9 splenoportal thrombosis without appreciable liver changes), the occurrence of episodes of digestive haemorrhage was statistically correlated with age, sex, type of portal impediment, type of collateral circulation, and the presence or otherwise of ascites, and with portal pressure values measured by splenomanometry. The only statistically significant correlation was that concerning the type of hepatofugal collateral circulation, as digestive haemorrhage proved gradually less frequent in patients with gastro-oesophageal collateral circulation, in those with so-called infraportal collateral circulation and, finally, in those where angiography was unable to demonstrate the presence of any collateral circulation at all.

Adolescent↗
PubMed1977

[Abnormal pulmonary vein outlet. Radiological aspects (author's transl)].

6 cases of abnormal pulmonary venous outlet, 5 of them partial anomalies without cardiocirculatory symptoms, are reported. Diagnosis was formulated by means of angiocardiography resorted to on the basis of the radiographic picture: retraction of the right hemithorax (left in 1 case), heart attraction, pulmonary veiling, tomographic pictures of anomalous vessels.

Adolescent↗