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Monica Campagnol M.D. Paolo Sapienza M.D. Filippo Napoli M.D. Mario Dauri M.D. Antonino Cavallaro M.D. F.A.C.S. F.I.C.A. 《The International journal of angiology》1995,4(4):193-197
Cultured, allogenic, human epidermal grafts have been successfully used to treat extensive burns, donor sites, leg ulcers, and eroded areas in recessive dystrophic epidermolysis bullosa. The following report describes the use of cryopreserved cultured human epidermal allografts in the treatment of long-standing ischemic ulcers unresponsive to conventional medical therapy in two patients who had previously undergone unsuccessful vascular reconstructive surgery. A marked reduction in ulcer size as well as rapid pain relief was achieved in both patients. In selected cases the use of epidermal grafts as a biologic topical therapy could represent an alternative to other medical treatments. However, thus far, only a few cases have been reported and the uncertain short- and long-term results as well as the excessive costs may limit the widespread application of this treatment modality. 相似文献
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Fattori R Napoli G Parlapiano M Fusco F Rapezzi C Bnà C Pierangeli A Gavelli G 《La Radiologia medica》1999,98(5):379-385
PURPOSE: To determine whether endovascular treatment of thoracic aorta conditions can be an effective alternative approach to surgical repair. MATERIAL AND METHODS: July 1997 to February 1999, eighteen patients (16 men and 2 women; 58.6 +/- 14.8 years) presenting with different kinds of descending aorta conditions were selected for the endovascular treatment. All patients exhibited severe comorbid pulmonary and/or cardiovascular medical conditions which increased surgical risk. All implants were performed in the operating room under fluoroscopic and TEE guidance. Clinical and imaging follow-up was performed 1, 3, 6 and 12 months later. RESULTS: The endovascular treatment was successful in 17 cases. No deaths or major complications occurred. No leakage was evident at post-procedure angiography. The patients were discharged after 6 +/- 4 days. MRI or CT study performed before hospital discharge showed aneurysms exclusion in 16 patients. In the four cases of dissection, thrombosis of the false lumen was evident since the first follow-up study. In the group of patients (11 cases) with 6 months follow-up, the diameters of stented aortic segments decreased. No late leakage was observed and thrombosis was complete in all cases. DISCUSSION: The natural history of aortic aneurysms and dissection is progressive toward dilation and aortic rupture. Surgery of descending thoracic aorta is burdened with a mortality of 8-12% in elective cases and over 50% in emergency cases or aortic dissection. The endovascular treatment of aortic conditions was introduced in clinical practice in 1991 and literature data show that it is effective, with lower mortality and morbidity rates than surgical treatment. CONCLUSION: Our results stress the feasibility and effectiveness of endovascular procedure in the treatment of complex thoracic aorta conditions even in high risk patients. Thus, endovascular treatment of thoracic aorta can be considered an effective alternative approach to conventional surgery. 相似文献
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Catalano C Pavone P Laghi A Panebianco V Fraioli F Pediconi F Napoli A Passariello R 《Acta radiologica (Stockholm, Sweden : 1987)》1999,40(6):644-648
OBJECTIVE: To determine the role of MR imaging in the localization of pancreatic insulinomas in patients with clinical and laboratory diagnosis of insulin-producing tumor. MATERIAL AND METHODS: Thirty-one patients presenting with signs and symptoms of pancreatic insulinomas were prospectively included in our study. Twenty-six patients underwent surgery, and pathologic specimens were examined: 5 patients, in whom the initial diagnosis of insulinoma was excluded, were also studied and then followed up. All patients were studied with a high gradient power 0.5 T magnet. Images were evaluated by 2 radiologists blinded to previous investigations, tests and results. RESULTS: MR imaging correctly localized 24 of the 26 insulinomas (2 were false-negative and 1 false-positive) and was correctly negative in the 5 control patients. The interobserver agreement had a kappa value of 0.89. CONCLUSION: MR imaging was accurate in localizing pancreatic insulinomas and as a consequence, patients in our institution are now submitted to surgery directly after the MR examination. Invasive methods are considered only in cases in which, despite clear biochemical results, MR imaging has not demonstrated a pancreatic focal lesion. 相似文献
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Di Napoli M 《Neurology》2000,55(7):1066-1067
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A 4 year old girl with neurofibromatosis type 1 (NF1) was referred for hypertension. An aortogram showed narrowing of the left main renal artery. An angiogram three and a half years later showed coarctation of the abdominal aorta. She underwent aortoplasty but the stenosis recurred. Vascular involvement in NF1 may be progressive and requires long term follow up. 相似文献
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