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1.
Federico Cagnazzo Pierre-Henri Lefevre Daniel Mantilla Aymeric Rouchaud Riccardo Morganti Paolo Perrini Davide Di Carlo Cyril Dargazanli Gregory Gascou Carlos Riquelme Alain Bonafe Vincent Costalat 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(1):9-14
Background and purpose
Placement of flow-diverters across the ostia of major ICA branches carries a risk of arterial occlusion. We determined the rate of occlusion of the supraclinoid ICA branches and the related symptoms, following coverage with flow-diverters.Materials and methods
A systematic search was performed in PubMed, MEDLINE, and EMBASE. We selected studies reporting treatments with flow-diverters in which the device was placed across the ostium of the OphtA, PcomA, or AchorA. Random-effects meta-analysis was used to pool the following outcomes: rate of arterial occlusion, diminished flow, incidence of related symptoms, factors associated with arterial occlusion.Result
Twenty-one studies evaluating 1152 supraclinoid ICA branches were included in the meta-analysis. The incidence of OphtA occlusion and associated symptoms was 5.9% (95 CI%?=?3.1–8.6%) (incidence rate?=?6% per patient-year), and 0.8% (95% CI?=?0.1–1.4%) (incidence rate?=?0.8% per patient-year), respectively. Although asymptomatic in all cases, PcomA showed a higher occlusion rate (20.7%, 95% CI?=?8.9–32.4%) (incidence rate?=?19.5% per patient-year). AchorA was occluded in 1% (95% CI?=?0.3–2.4%) of cases, with approximately 1% (95% CI?=?0.4–2.3%) of transient neurological symptoms (incidence rate?=?0.96% per patient-year). There was a trend toward higher odds of arterial patency among arteries arising from the aneurysm (OR?=?2.94, P?=?0.06). Demographic factors and multiple stents were not associated with higher risk of arterial impairment. Adequate collateral circulation was reported in 94.5% of patients with arterial occlusion.Conclusions
During aneurysm treatment, the ostium of the supraclinoid ICA branches can be covered with flow-diverter devices with low rates of neurological symptoms related to arterial occlusion. 相似文献2.
Gianfranco Sebastio Lucia Perone Vito Guzzetta Lucia Sebastio Laura Vicari Roberto Della Casa Fiorella Gurrieri Stefania Zappata M. Grazia Pomponi Attilio Mazzei Giovanni Neri Generoso Andria Christina Brahe 《American journal of medical genetics. Part A》1996,63(2):366-372
We report on an aneuploidy syndrome due to the unbalanced segregation of a familial translocation (4;21)(p16.3;q22.1) causing a partial 4p monosomy and a partial 21q trisomy. The three affected children presented with severe failure to thrive, short stature, microcephaly, profound hypotonia, and mental retardation. The face, very similar in the three children, is characterized by frontal bossing, upslanting of the palpebral fissures, short nose, and deep set ears, giving the overall appearance of the Down syndrome. The molecular study has defined the aneuploid segment on both 4p and 21q. Most of the Down syndrome critical region was found to be trisomic, while only part of the candidate Wolf-Hirschhorn syndrome critical region was deleted, suggesting that this region is not critical for the major malformations characteristic for WHS. © 1996 Wiley-Liss, Inc. 相似文献
3.
Background: The BioEnterics Intragastric Balloon (BIB?, BioEnterics, Santa Barbara, CA) in association with restricted diet
has been used for the treatment of obesity and morbid obesity. Methods: Since March 1998, 322 BIB were placed in 281 obese
and morbidly obese patients; 73 patients were male and 208 female; mean age was 41.6 years (21-70); mean weight was 117.4
kg (67- 229); mean BMI was 41.8 kg/m2 (29-81); % excess weight was 62% (10-216). The balloon was inserted and removed endoscopically under general anesthesia.
Patients were given a balanced diet of 1000 kcal/day.Also, for 18 months we compared 42 obese patients treated only with 1000
kcal/day diet (group A) with 31 obese patients subjected to BIB for 4 months + 1000 kcal/day diet (group B). Results: After
4 months of balloon treatment, the mean weight loss was 13.9 kg and the mean reduction in BMI was 4.8. Weight loss was greater
in male patients. Weight loss was accompanied by an improvement of the diseases associated with obesity, in particular diabetes.
In the diet vs BIB+diet study, BIB with diet produced a greater weight loss in a shorter time than diet alone. Conclusion:
The best indications for BIB were: morbidly obese opatients (BMI>40) and super-obese patients (BMI>50) in preparation for
bariatric operations; obese patients with BMI 35-40 with co-morbilities in preparation for bariatric surgery; obese patients
with BMI 30-35 with a chronic disease otherwise unresolved; patients with BMI <30 only in a multidisciplinary approach. 相似文献
4.
Palmieri S Sebastio L Mele G Annunziata M Annunziata S Copia C Viola A De Simone M Pocali B Schiavone EM Ferrara F 《Leukemia research》2002,26(6):539-543
Seventeen patients affected by acute myeloid leukemia (AML) with t(8;21) were prospectively programmed to receive three courses of high-dose cytarabine (HDARA-C) as post-remission therapy. The median age was 39 years and in all cases t(8;21) was the only karyotypic abnormality. Complete remission (CR) was achieved in 14 out of 17 cases (82%) and, after first consolidation with NOVIA regimen (intermediate dose ARA-C plus mitoxantrone), all patients received the three planned courses of HDARA-C (3g/m(2) q12h on days 1, 3, 5). There were two documented infections, while all patients experienced fever of unknown origin (FUO). Nonhematological toxicity was mild. Thirteen out of 14 patients are in continuous CR after a median follow-up of 44 months. One patient relapsed at 16 months and, following CR2 achievement, underwent allogeneic transplantation; he died 3 months later while in CR from acute graft versus host disease (GVHD). Survival at 5 years is projected at 79%. Our data confirm the efficacy of repeated courses of HDARAC for patients with t(8;21) AML. 相似文献
5.
6.
Gambassi G Semeraro R Suma V Sebastio A Incalzi RA 《The journals of gerontology. Series A, Biological sciences and medical sciences》2005,60(4):520-523
An 82-year-old Caucasian man presented with initially asymptomatic livid red plaques on the plantar surface of the feet that become confluent and evolved into invasively growing nodules accompanied by massive edema. Histology allowed a diagnosis of the classical form of Kaposi's sarcoma; the serology test result for HIV was negative, whereas the associated human herpes virus type 8 was detected by polymerase chain reaction on the skin sample. Over the subsequent 6 months, skin lesions become vegetative and partially necrotic, and extended to the hands and eyelids. Chemotherapy with vinblastine appeared to stabilize the cutaneous disease, but the patient developed a massive gastrointestinal hemorrhage secondary to dissemination to the stomach. Twelve months after the onset of the disease, vegetative and easily bleeding lesions progressively occluded the mouth of the patient: histological features were consistent with a low-grade angiosarcoma distinct from that of Kaposi's sarcoma. The patient could not chew and swallow anymore; he was put on an artificial nutrition but died shortly thereafter. This case illustrates that, even in its classical form, Kaposi's sarcoma may be a malignant, rapidly progressing tumor. LEARNING POINTS: a) The extent and rate of spread of initial skin lesions should be considered to be early signs of aggressive dissemination, even in the absence of other variables (i.e., histological pattern, human herpes virus type 8 positive mononuclear cells) associated with progression of the disease. b) An endoscopy may be useful given the high prevalence of gastrointestinal involvement. c) When classical Kaposi's sarcoma displays aggressive behavior a second, primary malignant tumor arising from the vascular tissue should be investigated. TAKE-HOME MESSAGE: Even in its classical form, Kaposi's sarcoma may be a malignant, rapidly progressing tumor with visceral involvement; also, a second malignancy may occur in nearly one patient of four. Because localized skin lesions can regress completely with radiotherapy, watchful waiting is probably inappropriate in most cases. 相似文献
7.
AIM: This study aimed to measure the thickness of radicular dentine and cementum in incisors, canines and premolars, and to develop geometric average models. METHODOLOGY: The roots of 220 extracted human teeth were sectioned in three horizontal parallel planes and measured using an optical microscope. For each cut surface buccal, lingual, mesial, and distal thickness of the root wall was measured. Mean values of the thickness at each location of each cut surface were calculated. The observed differences in thickness by tooth type, location, and section were compared by ANOVA and Student's t-test. RESULTS: Maxillary central incisors and maxillary canines had the greatest widths. In all teeth with a single root, the wall thickness were greater on the lingual side than the buccal side. Although differences between mesial and distal thicknesses were not statistically significant. CONCLUSIONS: Wall thickness varied greatly. The lingual surfaces of roots were larger. All roots had thin walls in the apical third. 相似文献
8.
In some cases of primary transitional cell carcinoma (TCC), there may be some uncertainty in clinical decision making. We present a case in which a pT1-N0 urothelial tumor was found in the renal pelvis after an open nephrectomy for urolithiasis. Because incomplete excision of the ureter can lead to recurrence of the TCC, we deemed it necessary to remove the residual ureter. Therefore, a combined endoscopic-transvescical laparoscopic ureterectomy was performed. The transabdominal approach was chosen for the procedure, because the patient had already undergone open nephrectomy with retroperitoneal access and was thus likely to have adhesions and inflammation in the region. For the endoscopic phase of surgery, a technique of ureteral intussusception was combined with transurethral resection. The choice of the endoscopic transurethral procedure was prompted by the fact that transurethral resection of the ureteral orifice and invagination ureterectomy has already been proposed as the first step of nephroureterectomy. The combined endoscopic laparoscopic procedure was not technically demanding; the ureterectomy took no longer than an open procedure. The surgery was uneventful, and the patient resumed normal activities the day after surgery. The broader issue of whether this technique should be adopted by the urological community at large as a routine practice requires longer follow-up outcome data. 相似文献
9.
10.
Summary Intracranial enterogenous cysts are an uncommon entity rarely found in the midline within the posterior cranial fossa. The
occurrence of an enterogenous cyst in the cerebellopontine angle is exceptional. We present two new cases of cerebellopontine
angle (CPA) enterogenous cysts and review the literature to clarify the diagnosis and the management of these lesions.
Eighteen cases of CPA intradural enterogenous cysts have been reported to date, including the two cases presented in this
article. All of them were symptomatic and underwent surgical treatment. After surgery, the symptomatic recurrence occurred
in 31% of the patients, most of which had partial excision. Considering our patients and the published cases in the literature
we suggest that the aim of surgery should be total removal of cyst and its content whenever possible. When partial resection
of the cyst is performed, we recommend long-term clinical and neuroradiological follow-up.
Correspondence: Paolo Perrini, MD, Neurosurgical Department, Hope Hospital, Salford, Manchester, UK. 相似文献