Nineteen aneurysmal bone cysts and five angiomas of bone were treated by selective arterial embolization. The median follow-up was 22 months. In 17 patients healing occurred with complete relief of symptoms; in 11 of these almost complete ossification of the lesion resulted. In the remaining cases, little or no ossification was apparent but ossification may take 1 year or more to occur. No recurrence was observed in any of these cases. Recurrence occurred only in two cases. In one, growth of the recurrence stopped after a second embolization, and the X-rays showed no change. Selective arterial embolization represents a treatment of choice in aneurysmal bone cyst and angioma of bone especially of the spine, sacrum, or pelvis. In these sites embolization replaces surgery which might be hazardous due to intraoperative bleeding.
Background. Most patients with hepatocellular carcinoma (HCC) are not suitable for surgical therapy. Systemic chemotherapy, immunotherapy, and hormonotherapy have not had convincingly acceptable results. Therefore, transarterial catheter‐targeted therapies such as intraarterial chemotherapy (IAC), possibly followed by transcatheter arterial chemoembolization (TACE), have been proposed. Methods. A survival analysis curve was drawn using the Kaplan‐Meier method for 164 patients, 100 with HCC who underwent TACE (69) or IAC (31), and a matched historic group of 64 who did not receive specific antineoplastic treatment. Results. A significantly more favorable survival was observed for TACE‐treated patients compared with IAC‐treated patients (P < 0.001); TACE‐ and IAC‐treated patients had a statistically superior survival than that of untreated patients (P < 0.001 and P < 0.025, respectively). This difference was still significant (P < 0.001) when the patients were subdivided into Classes A and B and Stages I and II following Child's and Okuda's criteria. The TACE‐ and IAC‐treated groups had a good relationship between technical efficacy of therapy and survival. Stratifying the patients according to the degree of iodized oil (Lipiodol Ultrafluid, Guerbet, Aulnay‐Sous‐Bois, France) uptake in the three groups with Group 1 having an uptake greater than 75% of tumor mass, Group 2 having an uptake of 50%‐75%, and Group 3 having an uptake less than 50%, survival at 6, 12, 24, 36, and 48 months was calculated as 94%, 88%, 67%, 53%, and 30%, respectively, for Group 1; 86%, 68%, 13%, 13%, and 0% for Group 2, and 43%, 23%, 6%, 6%, and 0% for Group 3 (Group 1 vs. Group 2: P < 0.001; Group 1 vs. Group 3: P < 0.001; Group 2 vs. Group 3: P < 0.001, respectively). The most important side effects after the intraarterial procedure were fever (46.2%), abdominal pain (36.6%), chemical cholecystitis (8%), and pancreatitis (1.7%). Death strictly related to treatment occurred in two patients; one had massive bleeding due to ruptured esophageal varices, and the other had a subphrenic abscess of a superficial HCC of the VIII segment. Conclusions. Transcatheter arterial chemoembolization and IAC were effective and relatively safe, and the authors believe that they have a primary role in treating patients with unresectable HCC larger than 5 cm; iodized oil uptake can be considered a suitable prognostic marker.
The angiographic visualization, arterial origin and mean diameter per age group (20-40, 41-60 years) of the suprarenal arterial vessels have been quantitatively investigated by aortography in 100 patients without suprarenal disease. Visualization of the various arteries was achieved in a percentage substantially comparable to the anatomic data of the literature, though with lower detection of the superior suprarenal vessels. A variable site of origin was present particularly for the superior and middle suprarenal vessels compared to the inferior suprarenal arteries and possible embryological reasons and clinical implications are discussed. Statistically significant differences were found in the mean diameter of each arterial vessel in all the subjects examined, thus substantiating the concept of differential arterial supply to various portions of the gland. Age-related changes were demonstrated in the right middle suprarenal artery, suggesting a predominant role of this vessel in the physiological adaptation of the blood supply to the gland with increasing age.
The present paper concerns an environmentally sustainable neighborhood planning project, as part of the smart community, located in the municipality of Ladispoli, in the Metropolitan area of Rome, along the Tyrrhenian coast. The project was designed as a solution to two current issues, involving all the major urban areas of the Northern Hemisphere: the ageing population and the young New Immigrants Citizens integration; the purpose is, therefore, to create an intergenerational space of mutual support and exchange among the local residents. The latter includes residential buildings NZEB (net zero-energy building) that are eco environment-friendly, designed with new building technologies based on the reuse of the main municipal solid waste, facilities minimization and the integration of renewable energy sources. The complete utilization of the local waste production in order to realize modules with low environmental impact is a key requirement to increase the overall environmental sustainability of buildings. An additional distinctive feature of this proposition is linked to the requirement of the dwelling flexibility, enabling those who live in it to easily adapt the apartments to their changing needs during a lifetime, also facilitating the integration among the different generations. The common thread of sustainability involves not only the housing project but also the dimension of a wider space, where green space plays a key role. Urban greenery is not by itself a boundary line between areas and activities, but attempts to re-establish equilibrium and natural functions that are essential for citizens' quality of life. The residential complexes are inserted in a planimetric urban design with leaflike shape and functions; some of the strong points of this project are the use of local and renewable resources, the use of active systems for energy production and passive technologies to reduce CO2 emissions, and the improvement of air-quality-enhancing green spaces.
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