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Andrea Ianniello,Gianpaolo Carrafiello,Paolo Nicotera,Adriano Vaghi,Alberto Cazzulani 대한영상의학회 2013 Korean Journal of Radiology Vol.14 No.2
A pulmonary artery aneurysm is a common manifestation and the leading cause of mortality in Behc¸et’s disease. We describe a case of spontaneous rupture of a pulmonary artery aneurysm that, due to the inadequacy of medical therapy and the disadvantages of surgery, became the ideal candidate for endovascular management and was successfully performed by using the Amplatzer Vascular Plug 4.
Burn-in Procedure Based on a Dependent Covariate Process
Cha, Ji Hwan,Pulcini, Gianpaolo Cambridge University Press 2015 Advances in applied probability Vol.47 No.2
<P>Burn-in is a method of ‘elimination’ of initial failures (infant mortality). In the conventional burn-in procedures, to burn-in a component or a system means to subject it to a fixed time period of simulated use prior to actual operation. Then those which fail during the burn-in procedure are scrapped and only those which survived the burn-in procedure are considered to be of satisfactory quality. Thus, in this case, the only information used for the elimination procedure is the lifetime of the corresponding item. In this paper we consider a new burn-in procedure which additionally employs a dependent covariate process in the elimination procedure. Through the comparison with the conventional burn-in procedure, we show that the new burn-in procedure is preferable under commonly satisfied conditions. The problem of determining the optimal burn-in parameters is also considered and the properties of the optimal parameters are derived. A numerical example is provided to illustrate the theoretical results obtained in this paper.</P>
Use of the ultrasound-based total malignancy score in the management of thyroid nodules
Giovanni Guido Pompili,Silvia Tresoldi,Anna Ravell,Alessandra Primolevo,Giovanni Di Leo,Gianpaolo Carrafiello 대한초음파의학회 2018 ULTRASONOGRAPHY Vol.37 No.4
Purpose: The purpose of this study was to validate the role of the total malignancy score (TMS)in identifying thyroid nodules suspicious for malignancy through the sum of their ultrasoundfeatures. Methods: The local ethical committee approved this prospective observational study. Weexamined 231 nodules in 231 consecutive patients (164 females and 67 males; age range, 20 to87 years; median age, 59 years; interquartile range, 48 to 70 years) who underwent ultrasoundfollowed by fine-needle aspiration cytology (FNAC). The nodules were further classified usingthe TMS, which considers ultrasound features (number, echogenicity, structure, halo, margins,Doppler signal, calcifications, and growth), and the Bethesda System for Reporting ThyroidCytopathology (TBSRTC), which considers cytological features. Patients with non-negativenodules (TBSRTC categories III to VI) underwent histological analysis, repeated FNAC, or 2years of regular ultrasound follow-up. The associations between the final diagnosis, each of theultrasound features, and the TMS were estimated using the chi-square test, the Mann-WhitneyU test, and multivariate logistic regression. A receiver operating characteristic (ROC) curve wasused to evaluate the diagnostic accuracy of the TMS. Results: On ultrasound, 47% of the nodules (108 of 231) had a TMS <3, 18% (42 of 231) hada TMS of 3, and 35% (81 of 231) had a TMS >3. The FNAC results of 85% of the nodules (196of 231) were benign, while 15% (35 of 231) had non-negative results. Hypoechogenicity, solidstructure, the presence of microcalcifications, and the number of nodules were independentpredictors of the final diagnosis, and the diagnostic accuracy of the TMS was good (area underthe ROC curve, 0.82). Conclusion: The TMS system is simple to use, reliable, easily reproducible, and closely reflectsmalignancy risk. Based on our results, FNAC could be limited to nodules with a TMS ≥3 withoutmissing any cases of carcinoma.
Tommaso Cai,Francesca Pisano,Gabriella Nesi,Vittorio Magri,Paolo Verze,Gianpaolo Perletti,Paolo Gontero,Vincenzo Mirone,Riccardo Bartoletti 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.6
Purpose: The role of Chlamydia trachomatis (CT) infection in chronic bacterial prostatitis (CBP) is well known. What is unclear is whether there are any differences in the course or clinical outcome of the disease when the cause is CT or other uropathogens. Materials and Methods: A series of 311 patients affected by CBP due to CT (cohort A) was compared with a group of 524 patients affected by CBP caused by common uropathogen bacteria (cohort B). All participants completed the following questionnaires: National Institutes of Health Chronic Prostatitis Symptom Index, International Prostate Symptom Score, International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD), Premature Ejaculation Diagnostic Tool (PEDT), and the Short Form 36 (SF-36) Health Survey. All patients were followed with clinical and microbiological evaluations. Results: After a mean follow-up time of 42.3 months, the number of symptomatic episodes was significantly higher in patients in cohort A than in cohort B (4.1±1.1 vs. 2.8±0.8, p<0.001), and the mean time to first symptomatic recurrence was shorter in cohort A than in cohort B (3.3±2.3 months vs. 5.7±1.9 months, p<0.001). Moreover, scores on the SF-36 tool were significantly lower in cohort A (96.5±1.0 vs. 99.7±1.9, p<0.001) at the first symptomatic recurrence. Cohort A also showed significantly lower scores on the IIEF-15-EFD and PEDT questionnaires at the end of the follow-up period (26.8±2.9 vs. 27.3±3.3, p=0.02 and 11.5±2.3 vs. 4.5±2.8, p<0.001, respectively). Conclusions: Patients affected by CBP due to CT infection have a higher number of symptomatic recurrences with a more severe impact on quality of life.
Use of Amplatzer Vascular Plug to Treat a Biliary Cutaneous Fistula
Anna Maria Ierardi,Federico Fontana,Monica Mangini,Filippo Piacentino,Eugenio Cocozza,Emila Frankowska,Chiara Floridi,Gianpaolo Carrafiello 대한영상의학회 2013 Korean Journal of Radiology Vol.14 No.5
Several substances have been used in an attempt to sclerose biliary ducts associated with persistent biliary-cutaneous fistula (BCF). The AMPLATZER Vascular Plug (AVP; AGA Medical, USA) system is a recently developed endovascular occlusion device, introduced as an alternative to permanent embolic materials (metallic coils or acrylic glue), in the occlusion of large and medium-calibre arteries and veins. We report a successful use of the AVP to embolize BCF, developed after the removal of an internal-external biliary drainage.
Nicola Flor,Alessandro Campari,Anna Ravelli,Maria Antonietta Lombardi,Andrea Pisani Ceretti,Nirvana Maroni,Enrico Opocher,Gianpaolo Cornalba 대한영상의학회 2015 Korean Journal of Radiology Vol.16 No.4
Contrast-enhanced computed tomography colonography (CE-CTC) is a useful guide for the laparoscopic surgeon to avoid incorrectly removing the colonic segment and the failure to diagnose of synchronous colonic and extra-colonic lesions. Lymph node dissection and vessel ligation under a laparoscopic approach can be time-consuming and can damage vessels and organs. Moreover, mesenteric vessels have extreme variations in terms of their courses and numbers. We describe the benefit of using an abdominal vascular map created by CE-CTC in laparoscopic colorectal surgery candidates. We describe patients with different diseases (colorectal cancer, diverticular disease, and inflammatory bowel disease) who underwent CE-CTC just prior to laparoscopic surgery.