RESUMEN
OBJECTIVES: The aim of this study was to focus on patients suffering from cochleo-vestibular disorder with and without Ménière disease (MD) in order to verify whether chronic cerebrospinal drainage abnormalities could play a role in the etiopathogenesis of endolymphatic hydrops. METHODS: Fifty-two volunteers were enrolled and subdivided into two groups: 24 definite MD and 28 not-MD. Both magnetic resonance venography imaging with contrast-enhanced imaging of the venous cerebrospinal system (MRV) and venous echo-color Doppler (ECD) were performed. RESULTS: MRV showed abnormalities in 83% of MD and 57% of not-MD subjects (p < 0.001). Asymmetrical cervical venous flow, assessed by MRV, was confirmed by ECD in 62.5% of MD but in only 21.5% of not-MD subjects (p<0.001). CONCLUSION: Chronic cerebrospinal venous insufficiency might be the anatomical background, which provides a predisposing factor for the development of endolymphatic hydrops in MD patients.
Asunto(s)
Vena Ácigos/fisiopatología , Circulación Cerebrovascular , Venas Yugulares/fisiopatología , Enfermedad de Meniere/complicaciones , Médula Espinal/irrigación sanguínea , Insuficiencia Venosa/etiología , Adulto , Anciano , Vena Ácigos/diagnóstico por imagen , Venas Cerebrales/diagnóstico por imagen , Enfermedad Crónica , Enfermedades Cocleares/fisiopatología , Hidropesía Endolinfática/etiología , Femenino , Humanos , Venas Yugulares/diagnóstico por imagen , Angiografía por Resonancia Magnética , Masculino , Enfermedad de Meniere/fisiopatología , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Ultrasonografía Doppler en Color , Insuficiencia Venosa/diagnóstico , Insuficiencia Venosa/diagnóstico por imagen , Insuficiencia Venosa/fisiopatología , Enfermedades Vestibulares/fisiopatologíaRESUMEN
OBJECTIVES: To demonstrate the effectiveness and the safety of laser thermal ablation (LTA) in patients with unresectable hepatocellular carcinoma (HCC) deemed not accessible for other percutaneous procedures (radiofrequency ablation, sclerotherapy). METHODS: From September 2003 to August 2008, 140 patients with HCC nodules were treated. In 49 patients, the lesions were localized in "critical sites". A total of 29 men and 20 women (age range 51-79 years; Child-Pugh score A = 75.51%, B = 24.49%) with 52 nodules (mean diameter 2.0 +/- 1.2 cm) were treated in 95 percutaneous LTA sessions. We compared major and minor complications observed in the two groups of patients. Effectiveness was defined as the percentage of HCCs completely ablated after percutaneous LTA. Follow-up was carried out with computed tomography (CT) at 1, 3, 6, 9, and 12 months. RESULTS: No major complications or deaths were registered. In a few patients (8.16%), minor complications were observed. No substantial differences were observed on comparing the percentage of minor and major complications in these patients with the remaining patients. A difference in terms of effectiveness was found. CONCLUSION: LTA can be considered a safe treatment in "critical nodules".