Complications after percutaneous transaxillary implantation of a catheter for intraarterial chemotherapy of liver tumors: clinical relevance and management in 204 patients.

Objective: The purposes of the study were to evaluate the complications of patients who underwent percutaneous transaxillary implantation of a permanent catheter-port system for intraarterial hepatic chemotherapy and determine their clinical relevance and specific management. SUBJECTS AND METHODS. Catheter-port systems were placed in 204 patients with liver tumors (86.

Cloning, purification, crystallization and X-ray analysis of the Escherichia coli pyrimidine nucleoside hydrolase YeiK.

The E. coli yeiK gene product is homologous to members of the nucleoside hydrolase family of enzymes, the physiological role of which in bacteria is still unknown. Here, the cloning, expression in milligram quantities and enzymatic characterization of YeiK as a pyrimidine-specific nucleoside hydrolase is reported.

Obsessive compulsive disorder among idiopathic focal dystonia patients: an epidemiological and family study.

Background: A disturbed function of striato-thalamo-cortical circuitry is hypothesized to underlie idiopathic focal dystonia (IFD) and obsessive compulsive disorder (OCD), two severe and disabling neurologic and psychiatric disorders. Previous studies on small samples showed either higher obsessionality scores or higher frequency of OCD in dystonic patients than in normal control subjects. The aim of this study was to evaluate the frequency and familial loading of OCD in a population of patients with IFD.

Hemorrhage from a right hepatic artery pseudoaneurysm: endovascular treatment with a coronary stent-graft.

Purpose: To report a novel case demonstrating the successful endovascular treatment of a right hepatic artery pseudoaneurysm using a balloon-expandable coronary stent-graft.

Case Report: A 60-year-old woman underwent surgical treatment for a Klatskin tumor, but her postoperative course was complicated by serious blood loss. An emergent celiac angiogram through a right transfemoral approach demonstrated a small iatrogenic pseudoaneurysm in the proximal right hepatic artery.

The role of radiology in the diagnosis and management of Takayasu's arteritis.

In the last years new computer-based imaging techniques, like color Doppler sonography, Computed Tomography, and Magnetic Resonance, have allowed a non-invasive approach to vascular diseases, partially replacing angiography, and increasing the role of radiology in the diagnosis and management of many chronic diseases, such as Takayasu's arteritis. Simultaneous evaluation of luminal and vascular wall changes may now allow a simpler diagnosis of this condition also in its early phase and the effective therapy monitoring. Application of new procedures of interventional radiolgy provides a safer and more conservative correction of late steno-occlusive complications.

Trigeminal autonomic cephalgia with periorbital ecchymosis, ocular hemorrhage, hypertension and behavioral alterations.

We describe a 38-year-old male in whom severe unilateral headache was associated with marked palpebral edema, periorbital ecchymosis, lacrimation, conjunctival injection, nasal congestion and rhinorrhea. A second, less severe headache form developed subsequently. The patient often presented severe labile hypertension and behavioral disturbances during the crises, and there was an episode of intra-ocular hemorrhage.

Occurrence of thyroid autoimmunity in relapsing remitting multiple sclerosis patients undergoing interferon-beta treatment.

We analyzed the titer of antithyroid autoantibodies (Abs) and thyroid function in 17 multiple sclerosis (MS) patients undergoing interferon-beta (IFN-beta) treatment and in 40 MS control patients. Basal evaluation revealed normal thyroid function in all patients. Abs were detected in 5 IFN-beta-treated patients (29%) and in 4 MS control patients (10%).

Detrimental effects of acute heparin administration on ischemic threshold in patients with coronary artery disease.

Background: Recent studies have indicated that heparin administration might decrease endothelial nitric oxide production. The aim of this study was to investigate the effect of heparin on ischemic threshold.

Methods: Eighteen patients with a positive exercise test and proven coronary artery disease were submitted to a randomized, placebo-controlled trial using i.

Renal arterial stenosis: prospective comparison of color Doppler US and breath-hold, three-dimensional, dynamic, gadolinium-enhanced MR angiography.

Purpose: To compare color Doppler ultrasonography (US) with fast, breath-hold, three-dimensional, gadolinium-enhanced magnetic resonance (MR) angiography in detecting renal arterial stenosis.

Materials And Methods: Forty-five patients with clinical suspicion of renovascular disease were prospectively examined with intra- and extrarenal color Doppler US and breath-hold, gadolinium-enhanced MR angiography. Digital subtraction arteriography (DSA) was the standard of reference in all patients for the number of renal arteries and degree of stenosis.

A prospective, randomized clinical trial on perioperative feeding with an arginine-, omega-3 fatty acid-, and RNA-enriched enteral diet: effect on host response and nutritional status.

Background: The use of immune-enhancing enteral diets in the postoperative period has given contrasting results. The purpose of this prospective, randomized, double-blinded clinical study was to evaluate the effect of immunonutrition given perioperatively on cytokine release and nutritional parameters.

Methods: Patients with cancer of the stomach or colo-rectum were eligible.

Complications of pancreatic surgery and the role of perioperative nutrition.

Background: According to international guidelines, artificial nutrition may be indicated after pancreaticoduodenectomy (PD). This clinical study was designed to evaluate whether the route of administration and the composition of the postoperative nutritional support could affect outcome.

Methods: One hundred patients who underwent PD for cancer of the pancreatic head were prospectively studied.

Recognizing the motion of a graspable object is guided by handedness.

Subjects viewing a rotating screwdriver presented in a motion picture were asked whether it was screwing or unscrewing. A difference emerged in the performance of right- and left-handers. In right-handers, stimulus orientations particularly awkward for a right-hand grip determined higher response times, compared with visually equivalent but more comfortable orientations.

A disposable needle for frontalis suspension surgery in congenital ptosis.

In six patients affected by congenital ptosis, a disposable epidural anesthesia needle was used instead of a Wright needle for frontalis suspension surgery. For each of the patients in this study, the use of a disposable needle permitted smaller supra-brow area incisions with a minimal scar. The needle also created a smaller breach in the plane of levator aponeurosis and preaponeurotic fat, causing less tissue edema and bleeding than with a Wright needle.

Value of abdominal sonography and MR imaging at 0.5 T in preoperative detection of pancreatic insulinoma: a comparison with dynamic CT and angiography.

Background: Abdominal sonography, computed tomography (CT), angiography, and magnetic resonance (MR) imaging are the most widely used modalities for preoperative localization of insulinomas. CT and angiography are generally considered the techniques of reference, and the role of sonography and MR imaging in these patients is controversial. The purpose of this study was to compare these four modalities in a group of patients with pancreatic insulinoma and determine an effective radiological approach to this disease.

Autoimmunity and diabetic neuropathy.

Autoimmunity has been implicated in the pathogenesis of diabetic neuropathy. A number of putative target antigens have been investigated in the attempt to find a relationship between the presence of autoantibodies and the presence of neuropathy. Attention has been given to antibodies against nerve growth factor, adrenal medulla, sympathetic and parasympathetic structures, glutamic acid decarboxylase and phospholipids.

Gut function and immune and inflammatory responses in patients perioperatively fed with supplemented enteral formulas.

Objective: To evaluate if the perioperative administration of a supplemented enteral formula modulates selective inflammatory and immune variables and gut function after surgery.

Design: Prospective, randomized, double-blind, clinical trial.

Setting: Department of surgery, university hospital.

Atlantoaxial dislocation related to instilling eyedrops in a patient with Down's syndrome.

Purpose: To alert ophthalmologists of the risk of hyperextending the neck of patients with Down's syndrome while holding them to instill eyedrops.

Method: We describe a case of atlantoaxial dislocation related to instilling eyedrops in a 6-year-old girl with Down's syndrome.

Result: Early recognition of the problem allowed prompt treatment and partial recovery of the patient.

Plain and gadolinium-DTPA-enhanced MR imaging of hepatocellular carcinoma treated with transarterial chemoembolization.

Background: To assess unenhanced and gadolinium-enhanced magnetic resonance (MR) imaging patterns of hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE).

Methods: Thirty-two patients with 48 HCC lesions underwent MR imaging before and 15 days after TACE. Fifteen lesions were then surgically resected.

Proton magnetic resonance spectroscopy and intracranial tumours: clinical perspectives.

Proton magnetic resonance spectroscopy (1H-MRS) was applied to characterize intracranial tumours of different hystological types. Seventy patients with intracranial neoplasms were studied before receiving surgery, radiotherapy or chemotherapy. All tumours were characterized by reduced or absent N-acetylasparate and increased signal from choline-containing compounds.

Pancreatic adenocarcinoma: assessment of vascular invasion with high-field MR imaging and a phased-array coil.

Objective: We performed this study to determine the value of MR imaging for assessing vascular invasion in preoperative staging of pancreatic carcinoma.

Subjects And Methods: In 73 consecutive patients with an established diagnosis of pancreatic duct adenocarcinoma, spin-echo T1-weighted and breath-hold multiplanar gradient-recalled (MPGR) images were obtained at 1.5 T with a phased-array coil before and after bolus injection of gadopentetate dimeglumine.

New trends in nuclear oncology: current problems in diagnosis of neoplastic diseases.

The diagnosis of oncologic diseases requires four levels of imaging intervention: identification, characterization, staging, and follow-up. Diagnostic problems in the identification of neoplastic disease may be present both for screening and for symptomatic patients; until today, few screening studies have been organized (e.g.

A postgraduate teaching course in laparoscopic surgery.

A teaching course in laparoscopic surgery was addressed to 21 young postgraduates as a part of their general surgery program with the aim of making them familiar with the basic principles of laparoscopic surgery. The methodology was based on tutorial teaching and "learning by problems"; the students worked in little groups elaborating check lists, discussing problems, and practising with laparoscopic training devices. Theoretical learning, practical abilities, and efficacy of tutorial teaching were investigated at the end of the course: the participant's understanding of instrument function, mastering of equipment, and solutions to clinical problems were good, as were the efficiency and pleasantness of the didactic method.

Pancreatic carcinoma: MR assessment of tumor invasion of the peripancreatic vessels.

Objective: Our goal was to determine the value of MRI in the assessment of vascular invasion in the preoperative staging of pancreatic carcinoma.

Materials And Methods: In 53 consecutive patients with an established diagnosis of pancreatic ductal adenocarcinoma, SE T1-weighted and breath-hold gradient echo images at 0.5 T were obtained before and after bolus injection of Gd-DTPA.

Automatic eye tracker for excimer laser photorefractive keratectomy.

Acute overlapping of successive laser pulses onto the cornea during photorefractive keratectomy (PRK) is important to avoid refractive distortions. Most excimer laser systems performing corneal ablation lack control of the patient's eye movements and they cannot track the target corneal zone. We developed an eye-tracker based on television monitoring of the pupil and on automatic electro-mechanical deflection of the laser turning mirror, and we applied it to the ExciMed UV200 ArF work station (Summit Technology, Inc.