Inferior vena cava leiomyosarcoma: establishment of an international registry.
Explore the source record for details and available documents.
Humans↗
Biomedical subjects
V Sciacca
Publications and source records attributed to V Sciacca.
Natural history of entrapment of the popliteal artery.
Popliteal artery entrapment (PAE) is described with increasing frequency. Reviewing the world literature and corresponding with some investigators, we were able to collect 375 instances in 291 patients, including our personal experience (33 instances in 24 patients). The present study was done to establish the natural history and evolution of PAE. Two groups of patients were created to verify if an early diagnosis and treatment of PAE is justified. Group 1 included 129 patients treated by a simple musculotendinous section. In group 2, 226 patients were treated by a vascular procedure (bypass, thromboendarterectomy, other). Age, symptoms and arteriographic findings were the parameters considered in the two groups. Results demonstrated that patients in group 1 are younger than those in group 2 (p < 0.001). Preoperative symptoms demonstrated a larger number of mild symptoms (paresthesias, a cold foot and cramping after intensive physical training) in group 1, when compared with group 2 (p < 0.001). Arteriography demonstrated a larger number of patients with normal findings at rest, with popliteal stenosis or occlusion during maneuver, in group 1 than in group 2 (p < 0.001). PAE results in progressive arterial impairment. Early noninvasive screening is mandatory to detect PAE at an early stage. Surgical treatment is thereby limited to a musculotendinous section, which has the best results.
Adult↗
Clinical results of epidural spinal cord electrical stimulation in patients affected with limb-threatening chronic arterial obstructive disease.
Between 1982 and 1990, 76 patients (33 women, 43 men, mean age 71.4 +/- 10 years) affected with limb-threatening peripheral vascular disease (claudication < 20 m: 3 patients; rest pain: 10 patients; necrosis1 smaller than 3 cm2: 28 patients; necrosis2 larger than 3 cm2: 35 patients) not amenable to medical and/or surgical therapy, were treated by epidural spinal cord electrical stimulation (ESES). Effectiveness of ESES was evaluated by consideration of pain control, walking distance, and healing of ischemic lesions. At a mean follow-up of twenty-six months (range: one to seventy-six) 44 limbs (58%) were amputated (rest pain 2; necrosis1 13; necrosis2 29) and 39% of necrotic lesions smaller than 3 cm2 healed. The overall limb salvage rate was 42%. Pain control was obtained in 80% of patients at the one-year and 75% at the two-year follow-up, with infrequent use of pain relievers. Despite the poor clinical results observed, the limb salvage rate testifies to the effectiveness of ESES in limb-threatening ischemia. Moreover, the authors noticed a good ESES effect on pain relief, maximal in the early and intermediate postimplant periods. In conclusion ESES must be considered the last resort in peripheral vascular disease in patients in whom medical and/or surgical therapies are ineffective or impossible. Necrotic lesions larger than 3 cm2 contraindicate, in their opinion, ESES implant.
Aged↗
[Mayer-Rokitansky syndrome. Case report].
Uterine anomalies associated with congenital renal agenesis and skeletal abnormalities represent an uncommon pathology that often presents important diagnostic problems. A case of Mayer-Rokitansky syndrome is reported. The embryologic, clinical, pathologic and therapeutic implications of this disease are briefly discussed.
Abnormalities, Multiple↗
Surgical treatment of popliteal artery entrapment syndrome: a ten-year experience.
Popliteal artery entrapment syndrome is increasingly described in the world literature as a cause of lower limb arterial impairment. It is caused by the anomalous interrelationship between the popliteal artery and its surrounding muscular and/or tendineous structures. The first case surgically treated was reported in 1959 and since then more than 300 cases have been reported including our personal experience (31 cases in 23 patients). We have treated surgically 19 males and four females with symptoms which were moderate (cramping after intensive physical training, paraesthesia, etc.) in 14 limbs, intermittent claudication in 16 and necrosis (first toe) in one. Preoperative arteriography showed arterial occlusion in eight limbs, stenosis in eight and aneurysms in two. In 11 limbs stenosis or occlusion was only shown after active plantar hyperextension and in two arteriography was not done because surgical indications were established on the basis of a venogram positive for popliteal vein entrapment syndrome. Ten different anatomical variants were seen and the medial head of gastrocnemius muscle was involved in 74.2%. Surgical treatment consisted of division of the aberrant musculotendinous tissue in 18 cases (in two of these balloon angioplasty was also used). In 12 cases a vascular reconstruction was also required, while one case was explored without a specific procedure being warranted. Optimal results were obtained when the syndrome was treated at an early stage by simple division of musculotendinous tissue (94.4% long-term patency rate, mean follow-up 46.0 months, min 2, max 120 months). When arterial grafting was required the long-term patency rate was only 58.3% (mean follow-up 43.5 months, min 1, max 100 months).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Diagnosis of popliteal artery entrapment syndrome: the role of duplex scanning.
The authors present a new diagnostic procedure to quickly and noninvasively diagnose the popliteal artery entrapment syndrome. A large personal experience on the surgical treatment of such a disease (29 cases in 22 patients) allowed us to focus on the optimal diagnostic procedure useful to detect this problem at an early stage. The technique is based on continuous-wave Doppler and duplex scanning studies done both in the resting state and during active contraction of the calf muscles. If compression of the popliteal artery occurs with contraction of the calf muscles, it will be detected by a decrease in flow. This finding will also direct the radiologist to obtain films when the maneuver is repeated. This makes it unlikely that the diagnosis will be missed. Since July 1988 a total of 1212 patients were evaluated with continuous-wave Doppler for suspected chronic ischemia. From this group 41 patients were selected to be studied again with the combined continuous-wave Doppler and duplex scanning method for possible popliteal artery entrapment syndrome. Two cases were discovered and verified by dynamic angiography guided by continuous-wave Doppler and treated surgically.
Adult↗
Evaluation of venous flow by light reflection rheography (LRR) in athletes performing track race.
The venous flow physiology in the athletes represents an interesting research field of sports angiology. The frequent observation of phlebectasias and/or varicose veins in athletes incited us to investigate the venous pathophysiological mechanisms predisposing them to such diseases. The maximal venous outflow (Rmax in millivolts) and the 1/2 venous refilling time (1/2 VRT in seconds) were evaluated in track racers, at rest and after exercise, by means of the light reflexion rheography (LRR). Thirty-two athletes (16 males, 16 females; mean age 23.4 years, range 15-37) were studied, dividing them in three groups: (A) 100 m (13), (B) 2,000 m (13), (C) 6 x 100 m with 2 minute recovery time (6). Among them six athletes performed the test wearing elastic compression stockings (25-32 mmHg). The results demonstrated a significant post-exercise modification of LRR curves and parameters in all groups, testifying superficial venous flow augmentation and deep venous flow overloading.
Adolescent↗
Thrombolysis of graft occlusion using high dose urokinase. An alternative to surgical treatment?
Two cases of acute leg ischemia from unilateral occlusion of an aorto-bifemoral graft, treated with high-dose urokinase intra-arterial infusion, are reported. This therapy allowed identification of the cause of thrombosis, recanalization of the graft and planning of reoperation. Indications for intra-arterial thrombolytic therapy and advantages of urokinase vs streptokinase are discussed.
Aged↗
Magnetic resonance imaging of abdominal aortic grafts.
The widespread use of abdominal aortic grafting procedures and increasing awareness of related complications suggests the need for a reliable and non-invasive diagnostic technique which will allow early detection of both occlusive and non-occlusive complications. Ultrasound is generally used with satisfactory results, but has several limitations, whereas MRI has shown great promise in the study of cardiovascular disease, being non-invasive, multiplanar and multiparametric. The present research aims to evaluate MRI in the follow-up of abdominal aortic grafts, attempting to define its significance as a screening procedure in non-selected patients. MRI is reliable in ascertaining the normality of the graft as well as the complications, these being partial or total thrombosis, pseudoaneurysms and perigraft collections. The data obtained are highly satisfactory and are almost always superior to those achieved with ultrasound and CT.
Aorta, Abdominal↗
[Surgical treatment of aneurysms of the abdominal aorta. Consecutive experience for 12 years].
The authors present their experience with abdominal aortic aneurysm during the last 12 years. From 1976 up to now they treated 70 patients with abdominal aortic aneurysms. Sixty-seven patients (96%) were male, while 3 (4%) female. Mean age was 65 years (S.D. +/- 7.97). 82% of the patients were heavy smokers. Sixty-five patients were treated by means of resection and vascular reconstruction. Their associated pathologies were: M.I. or severe heart ischemia 34 (52.3%), diabetes 13 (20%), hypertension 25 (38.4%), T.I.A. 6 (9.2%), renal insufficiency 13 (20%), and respiratory insufficiency 18 (27.6%). Results demonstrated a 12-year patency rate of 91.8%. Five high-risk patients were treated by means of "palliative" treatment. Associated pathologies and risk factors were: smoking 5 (100%), M.I. or severe heart ischemia 5 (100%), diabetes 2 (40%), hypertension 4 (80%), T.I.A. 2 (40%), renal insufficiency 2 (40%), respiratory insufficiency 3 (60%). Treatment consisted in the sac thrombosis by means of Gianturco-Wallace coils into the aneurysm (2 cases) and iliac artery ligation (3 cases). Both techniques allowed acute thrombosis of the aneurysm. Vascular supply to the lower limbs was performed by means of an axillo-bifemoral reconstruction in all cases. Long-term prognosis of these five patients was poor due to their general condition.
Aged↗
Percutaneous transluminal angioplasty of subclavian artery. Comparative study with axillo-contralateral bypass.
Explore the source record for details and available documents.
Adult↗
[Hemorheologic, metabolic and blood coagulation changes in diabetics in treatment with sulfanyl ureas].
A study was carried out to see if chronic treatment with a sulphanylurea with hypoglycaemic action, with also haemoactive action in terms of anti-platelet aggregation, profibrinolytic and antifibrinogenetic action also acted haemorheologically. For this purpose a group of patients treated with Gliclazide was compared with a group under treatment with Glibenclamide. A significant variation was noted in terms of an increase in erythrocyte filtrability and a diminution in erythrocyte aggregation with diminution in blood viscosity at low shear-rates. The absence of parallel modifications in quantitative corpuscular viscous factors, the early onset of the process, the real diminution in the sense of a reduction below the range of normality suggests that the effect is pharmacological and not mediated by metabolic compensation.
Blood Coagulation↗
Influence of knee flexion on femorodistal bypass hemodynamics.
The influence of knee flexion on the hemodynamics of ten Below Knee (B.K.) femoro-popliteal by-passes (mean follow-up 45 mos. min. 2-max. 134) has been studied by means of Doppler Pressure Index (P.I.) and Pulse Volume Recorder (P.V.R.). In all patients operative indication was limb salvage and the graft material was autologous saphenous vein (ASV) in 5 cases, PTFE in 3 and Dacron in 2. Calf and ankle P.I. and P.V.R. wave amplitude modifications have been evaluated bilaterally just after the beginning of knee flexion (80 degrees) and at 10 and 15 minute intervals. The knee flexion influenced detrimentally (p less than 0.025) the P.I. (calf: -10.9% at the beginning, -17.8% at 10 min. and -20.5% at 15 min.; ankle: -7.4% at the beginning, -13.6% at 10 min. and -16.5% at 15 min.). P.I. was minimally affected by knee flexion in non-grafted limbs (-3%). No consistent P.V.R. modifications were observed.
Blood Pressure↗
[Presentation of a method of interpreting erythrocyte deformability].
The physical principles of a method based on a haematic double filtration, according to Reid classic technique is explained. The aim is to determine a method for researching the characteristics of erythrocytic deformability, without changing the original medium, exoerythrocytic essential component of the membrane physiochemical quality and intraerythrocytic for the fast, active exchanges, after an evaluation of different techniques and instrumentation. A practical example for calculating the factor of correction, with reference to personal material, is made. This method has the advantage that it does not need the manipulation of the sample and does not delay the determination.
Biophysical Phenomena↗
[Macrocytosis in relation to the severity of the hepatopathy].
Among factors causing the hepatopath's relative erythrocyte macrocytosis, the influence of alcohol and liver function damage was compared. Hepatopathic macrocytosis is different from Biermer's macrocytosis and evidently involves different pathogenetic mechanisms. It is significant that a deficit in vit. B12 does not occur and a modest deficit in folates only rarely. There is much evidence of an alteration in lipidemia and particularly in apo-protein content. It is concluded that the two factors considered have different mechanisms but produce the same results.
Anemia, Macrocytic↗
[Hemorheology and acute in vivo changes in non-viscous serum factors].
During research into a real model permitting study of the rheological effect of serum constituents without viscous power, the viscous features of blood and plasma and erythrocyte deformability and aggregability were evaluated before and after dialysis in relation to variables acutely modified by therapy. Interdependence with certain serum factors often considered responsible for rheological changes in various pathologies after maximum alteration and, in the short term in the same subject, under normal conditions were controlled.
Adult↗
Therapeutic efficacy of ketanserin, a selective antagonist of the serotonin (5-HT2) receptors, in primary and secondary Raynaud's phenomenon.
Fourteen ambulatory and hospitalized patients with primary and secondary Raynaud's phenomenon have been examined before and after a thirty-one-day therapeutic trial. The treatment was conducted in two cycles. The first one lasted ten days, during which placebo was administered. The second cycle lasted three weeks, during which ketanserin, a selective antagonist of 5-hydroxytryptamine (5-HT2) receptors, was administered. The therapeutic effect consisted of the complete healing of digital ulcers in 4 of 5 patients and a considerable decrease in the number, length, and severity of daily attacks. To evaluate the digital blood flow, each patient was submitted to a medical dynamic telethermographic test. This, after the cooling test, demonstrated an average decrease of twenty minutes in the time necessary to reestablish basal thermal conditions (T') at the end of an adequate period of therapy using optimal doses of the drug. The authors affirm that orally administered ketanserin has a beneficial effect and can be well tolerated in subjects with Raynaud's phenomenon.
Adult↗
[Associated hepatitis B virus forms and analysis of immunologic configurations in histologically typified chronic diseases of the liver. Epidemiologic aspects and development factors].
We report histological aspect of population, expression of middle classes of Lombardia (Italy), affected by hepatomegaly with or without marks of biohumoral compromised. After classification in groups, according to a minutely explained scheme, we investigate the hepatitis B virus (HBV) immunological aspect and the frequency of the several configurations in every group. We have found HBV positive almost half hepatopathies classified as metabolic according to histological features and 70% of the liver cirrhosis without histological signs of inflammation. The immunological shape showed by last group is identical to the shape of the group with typical histological signs of persistent chronic hepatitis. Another epidemiologic factor as age marks the different histological groups and leads to advance hypotheses of consecutiveness. Distribution of the different histological forms with reference to sex allows the same considerations on pathogenetic factors of progression.
Adolescent↗