1161. Computed tomographic angiography of body vasculatureTomaž Kunst, Pavel Berden, 2000, review article Abstract: Background. The introduction of helical CT scanners in combination with simultaneous opacification of vessels with contrast medium allows the demonstration of vessels within the chosen volume of interest. This examination is called CT angiography. Being a minimally invasive method, it has been quickly accepted in the spectrum of vessel-imaging modalities, as forexample: Doppler ultrasound, magnetic resonance angiography, transesophageal ultrasound etc. In the field of cardiovascular radiology, it has been used to demonstrate pathology of ascending and descending aorta, likethe aneurysms, dissection, traumatic rupture or congenital anomalies. It is also very useful in pre- and postoperative follow-up in the aortic stent-graft insertion, a method which has recently become popular. Also the CTangiography has greatly influenced the preoperative calculations and has clearly demonstrated the postoperative anatomical changes as well as complications (i.e. peristental leakage). Conclusions. In this context, it is comparable to intraarterial angiography and even offers some advantages over the latter. The only draw-back being somewhat lower spatial resolution and longer processing time, but with the advent of a new, so called multi-slice scanners and powerful workstations, these draw-backs will be minimized.
Published in DiRROS: 24.01.2024; Views: 284; Downloads: 58
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1162. Computed tomographic angiography in intracranial vascular diseasesZoran Miloševič, 2000, review article Abstract: Background. The development of spiral computed tomography (CT) introduced a more precise imaging of the vessels also with computed tomographic angiography(CTA). Because it is a minimaly invasive method, it was widely accepted by radiologists and clinicians. In early 90ties CTA also accompanied conventional angiography and magnetic resonance angiography (MRA) in imaging of intracranial vascular diseases. CTA is used for the detection and evaluation of intracranial aneurysms, vascular malformations, stenoocclusive diseases of intracranial arteries and pathological changes of venous sinuses. Comparing to conventional angiography as the "gold standard", CTA has high specificity, sensibility and diagnostic accuracy concerning detections of intracranial aneurysms. Regarding vascular malformations, CTA is used for diagnostics and pre and postopeative evaluation of it. CTA can show good results in imaging of venous angiomas, and so invasive conventional angiography can be avoided in this pathology. Stenosis and occlusions of arteries can be diagnosed and evaluated in patients with cerebral vasospasm, patients with acute stroke, and patients with chronical arterial stenoses and occlusions. CTA is useful for the demonstration of occusive and stenosing changes of intracranial venous sinuses. Conclusion. With CTA it is possible togenerate threedimensional reconstructed images which give a more accurate determination of anatomical relations in intracranial vascular diseases. The main disadventage of CTA in comparison to intraarterial angiography is the lower spatial resolution of CTA, but is constantly imprving with the development of better scanners and workstations, so that there are great possibilities for further deveopement and wider use of CTA in the diagnosis ofintracranial vascaular diseases.
Published in DiRROS: 24.01.2024; Views: 192; Downloads: 46
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1163. Ultrasound-guided aspiration biopsy of subclinical regional metastases of head and neck carcinomaAlenka Višnar-Perovič, Aleksandar Aničin, Živa Zupančič, Bojana Černelč, Alojz Šmid, Dubravka Vidmar, Milan Gorenc, 2000, original scientific article Abstract: Background. Studies concerned with the estimation of ultrasound (US) combined with ultrasound-guided aspiration biopsy (USGAB) in the detection of subclinical regional metastases from the planocellular carcinoma of head and neck are promising, but in few cases. Recently, the authors have pointed out the role of lymph node size parameters in order to decide about the use of USGAB. The aim of this study was to test the reliability of US-USGAB for the detection of subclinical regional metastases in patients with planocellular head and neck carcinomas, including the evaluation of lymph node size parameters. Patients and methods. 121 neck sides with no palpable metastases were examined by US in 77 patients with planocellular carcinomas of head and neck. Depending on the results obtained, USGAB was performed on 64 neck sides.After surgery, the results of US-USGAB were compared with histological findings of the dissected lymph nodes. Results. The study showed 77% overall sensitivity of US and USGAB, and 100% specificity, while the versal / longiyudinal diameter was the best predictor of metastatic lymph node involvement. Conclusion. The results of this study established that USGAB is an appropriate method for detection the subclinical regional metastases on neck, and should be included into routine diagnostic work up in the evaluationof the extent of head and necks carcinomas.
Published in DiRROS: 24.01.2024; Views: 218; Downloads: 58
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1164. Endovascular treatment of aortic aneurysm by endoprosthesisMiloš Šurlan, Vladka Salapura, 2000, original scientific article Abstract: Aortic endoprosthesis are divided according to its shape, site of application,and construction material. Regarding the shape, there are tubular,unilateral and bifurcational endoprosthesis. Tubular are used mostly for treatment the thoracic aneurysm, and less for treatment of the abdominal aneurysms. For exclusion of abdominal aneurysm the bifurcational prosthesis ismostly used. Aortic endoprostheses are made of metallic support and prosthetic part. Supportive elements are made of stainless steel or nitinol, while the prosthetic part is made of dacron or PTFE. Metallic part of prosthesis attaches prosthesis to healthy part of aorta, above and below aneurysm, like sutures. It expands and gives support to the prosthesis. The procedure is precisely described for thoracic and abdominal aortic aneurysms. We describe the possible complications and the mechanism of leakage and its diagnosis. In the study are presented two cases of patients with aneurysm of thoracic aorta and one case with abdominal aorta, successfully treated in our Institution. The follow-up results after 2 years, in the patients with thoracic aortic aneurysm, and 6 months follow up in the patient with abdominalaortic aneurysm showed no signs of clinical or imaging complications.In conslusion, we were trying, on the basis of our experiences and results that have been recently published, to evaluate this method of treatment.
Published in DiRROS: 24.01.2024; Views: 243; Downloads: 61
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1165. Diagnostic imaging, indications and measurements for the treatment of aortic aneurysm by endoprosthesisMiloš Šurlan, Vladka Salapura, Tomaž Kunst, 2000, review article Abstract: Background. This paper presents imaging diagnostics of an aneurysm of the aorta, indications, common contraindications and measurements for the construction and selection of an endoprosthesis. The examination using ultrasound is the most handy and economically justifiable method for detectingan aneurysm of the aorta, for monitoring asymptomatic aneurysm as well as patients having undergone an operation or those with an endoprosthesis. Another examination to visualise the aortic aneurysm is CT with or without contrastive medium. The plan for treating an aneurysm can be made with the help of a DSA, helical CT angiography and/or MRA. DSA shows wellthe lightness of the aneurysm and the aorta, as well as the changes insideof it, large arteries close to the aneurysm and the condition of pelvic arteries for the selection of the approach. The helical CT angiography and MRAin two or three dimensional reproduction in several directions enable an accurate measurement of an aneurysm, the aorta diameter above and below the aneurysm, and the evaluation of the quality of its wall. Conclusions. The indication areas for endoprosthesis are aneurysm of the abdominal aorta and those of the descending part of thoracic aorta. The treatment with endoprosthesis as a less invasive method is indicated in patients who risk a number of complications and even mortality when treated surgically. Endoprosthesis is made of metal stent and prosthesis. The stent attaches the endoprosthesis to the unaffected part of the aorta above and below the aneurysm, it sets the stent asunder and provides support. The prosthesis is made of Dacron synthetic fabric, which has very good properties for this purpose such as small compliance, porosity, permeability and extensibility. The endoprosthesis is introduced into the aorta through a catheter system withthe help of a special guide wire. The entering point is surgically opened common femoral or iliac artery.
Published in DiRROS: 24.01.2024; Views: 270; Downloads: 66
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1166. Transjugular intrahepatic portosystemic shunt (TIPS)Miloš Šurlan, Janez Jereb, 2000, review article Abstract: Background. A clear presentation of TIPS indications and contraindications, which can be divided into absolute and relative, is given. Absolute indications are fresh and renewed bleeding of varices and inveterate ascites. Relative indications, on the other hand, are splenomegaly with hypersplenism, Budd-Chiari syndrome, liver transplantation and hepatorenal syndrome. Absolutecontraindications are severe liver dysfunction and right heart failure, while the relative ones polycystic liver degeneration, neoplasm, obstruction of the portal vein and severe local and systemic infection. Beforethe TIPS procedure, the level of dysfunction of the liver, right heart and kidneys is determined. Biochemical and blood tests, including a blood coagulation test, are made, the ammonia level in the serum is determined and possible obstructions/strictures of the portal vein are checked. A detailed description of the procedure, a care for patient and a operative monitoring are given. The success rate of the procedure is between 93% and 100% and the mortality rate within 30 days because TIPS is between 1% and 3%. The hemorrhage is stopped in 95% to 100%, the ascites is improved in 87% to 92% and the kidney function in 81%. In case of hypersplenism the thrombocytopenia is improved in 75% and leucopenia in 50% of patients. There are relatively fewcomplications during the procedure. Postoperative complications are more frequent due to stricture and obstruction of the shunt. After a two-year treatment the shunt is passable in 50% of patients. Thus, in a group of 29 patients, who were treated in the period of four years with an average monitoring period of two years, 22 patients (75,9%) are still alive and only 7died (24,1%). Six of dead patients suffered from alcoholic cirrhosis of the liver. In two cases the cause of death was not related to the TIPS and the cirrhosis of the liver. (Abstract truncated at 2000 characters).
Published in DiRROS: 23.01.2024; Views: 266; Downloads: 58
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1167. Defecography: a report on 35 casesBreda Jamar, Katarina Šurlan Popović, 2000, original scientific article Abstract: Purpose. To evaluate indications in the patients referred for defecography to our Institute between October 1996 and December 1999. Patients and methods. Inthis period, 35 patients (31 women and 4 men, their mean age being 56,5 and34,5 years, respectively) with defecation disorders disorders of 1 months to 17 years of duration were referred to us for defecography - 26 from proctology specialists and 9 from internal medical out-patient departments. After the rectum was filled with thick barium paste, spot shots from lateral position were made in different phases of defecation, with the patient sittingon a specially designed commode. Results. Rectocele was found in 21 cases, in 9 cases in association with rectorectal intussusception, in 3 with rectoanal intussusception and in 2 with herniation of rectal wall into ishiorectal fossa. Prolapse was found in 2 cases, and 4 rectorectal intussusception, 1 rectoanal intussusception and 3 fistulas were diagnosed. The findings were normal in only one case, while in 3 cases defectography showed functional abnormalities. In female patients, symptoms started after gynaecological operation in 11 cases and 6 cases after delivery. Eight women had to press perineum with their hand to faciliate defecation. Conclusions. Defecography proved useful in clarifying the pathology underlying patient's difficulties.
Published in DiRROS: 23.01.2024; Views: 242; Downloads: 59
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1169. Antitumor effectiveness of bleomycin on SA-1 tumor after pretreatment with vinblastineMaja Čemažar, Marija Auersperg, Gregor Serša, 2000, original scientific article Abstract: In our previous study, vinblastine (VLB) was shown to increase the plasma membrane fluidity. This effect of VLB might be exploited for better transport of drugs through the plasma membrane. The aim of the present study was to determine whether pretreatment with VLB can increase the cytotoxic effect of BLM on intraperitoneal SA-1 tumors in mice. Materials and methods. BLM and VLBwere used as single agents or in various combinations, i.e. BLM injected 24h before VLB or vice-versa, VLB injected 24 h before BLM. Cell and animal survival together with DNA histograms were the end-points used to determine the effect of these combined treatments. Results. Both drugs, either as singletreatment or in different combined therapy schedules reduced significantly the number of cells in peritoneal lavage, compared to control, saline treated animals. The combination of VLB, followed by BLM after 24 h reduced significantly the number of cells in peritoneal lavage, compared to the treatment in which BLM was followed by VLB or to the treatment with singledrugs alone. Median survival time of mice treated with VLB alone, BLM alone and combination of both drugs was significantly prolonged compared to the control untreated mice. When VLB and BLM were combined, both treatment combinations were more effective than monochemotherapies with VLB or BLM. The best results were obtained when VLB was followed by BLM after 24 h. The DNA histogram of cells treated with VLB showed a decreased number of cells in S phase and an increased number of cells with DNA values greater than in G2M compartment compared to the control untreated cells. BLM in the dosage used inthese experiments did not affect the progression of cells through cell cycle. Both combinations of VLB and BLM produced similar cell kinetic effect as VLB alone. Conclusion. (Abstract truncated at 2000 characters.)
Published in DiRROS: 23.01.2024; Views: 256; Downloads: 53
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1170. Cathepsin D and plasminogen activator inhibitor type 1 in normal, benign and alignant ovarian tissues : a preliminary reportMarina Šprem, Damir Babić, Marija Abramić, Duško Miličić, Ivan Vrhovec, Janez Škrk, Maja Osmak, 2000, original scientific article Abstract: Background. The aim of the present study was to determine the concentration ofcathepsin D (Cath D) and plasminogen activator inhibitor type 1 (PAI-1) in normal ovarian tissues, benign and malignant ovarian tumor tissues, and to asses relationship between Cath D and PAI-1 content, and some clinical and pathohistological parameters. Materials and methods. Cath D contents and PAI-1concentrations were determined (using immunoradiometric ELSA-Cath D assayand commercial IMUDIND R ELISA immunoassay, respectively) in 35 samples: 10 normal ovarii, 10 benign, 10 primary malignant and 5 metastatic ovarian tumors. Results. The concentrations of Cath D were significantly higher in malignant (32.89+-14.26 pmol/mg protein ) and metastatic (31.42+-10.24 pmol/mgprotein), than in normal (13.68+-4.03 pmol/mg protein) and benign (17.89+-13.13 pmol/mg protein) ovarian tissues. There was no statistical differences in the concentrations of PAI-1 between normal, benign, malignant and metastatic tumor specimens. The concentrations of Cath D as well as PAI-1 did not correlate to the age of patients, menopausal status, parity, GOG risk group, clinical stage or pathohistological grading. Conclusion. Concentrationsof Cath D (but not PAI-1) were significantly increased in malignant and metastatic ovarian tumor tissues when compared to normal and benign ovarian tumor samples; they were independent from pathohistological andclinical parameters.
Published in DiRROS: 23.01.2024; Views: 247; Downloads: 75
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