[Gastric lipoma. Report of 2 cases].
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Aged↗
Biomedical subjects
A Rotondo
Publications and source records attributed to A Rotondo.
[Computerized tomography in craniocerebral, maxillofacial, cervical, and spinal gunshot wounds. Part II--Clinical contribution and medico- legal aspects].
To assess the diagnostic and medicolegal contribution of Computed Tomography (CT) in patients with craniocerebral, maxillofacial, neck and spine gunshot wounds, we submitted to CT 106 patients with gunshot wounds examined over a 7-year period (February, 1988 to December, 1994). Twenty-four of them had craniocerebral injuries (23%), 9 maxillofacial (8%), 8 neck (8%) and 10 vertebral (9%) injuries. Emergency CT demonstrated the mechanism of the injury, the bullet path and site, the site of bone and/or metallic fragments, and damage extent. In all perforating cranioencephalic injuries (n = 7) intracerebral or extrathecal bone fragments were demonstrated adjacent to the bullet entrance and exit holes, respectively. In injury monitoring. CT showed injury evolution, retained fragments and complications, thus enabling damage extent assessment. High Resolution Computed Tomography (HRCT) was useful in locating minute orbitary retrobulbar and intraspinal fragments. Magnetic Resonance (MR) Imaging in postoperative patients proved a valuable tool to assess the extent of spinal cord damage. To conclude, CT is a useful technique to examine the patients with gunshot wounds, which helps plan adequate treatment and solve complex medicolegal problems.
Adolescent↗
[Role of anal endosonography in inflammation and trauma of the anal canal].
Anal endosonography (US) is a valuable tool to represent the normal anatomy of the anal canal and also to reliably examine patients with anal conditions. Our series consisted of 40 patients with suspected inflammatory and traumatic conditions of the anal canal submitted to anal US, which showed the presence of abscesses in 18 patients with suspected anal canal inflammation. A fistula was associated in 14 of the 18 patients and US after air injection easily showed a cutaneous orificium in 6 of the 14 patients. Anal US showed the presence and site of all abscessual foci and fistulae, also identifying the inner orificium and the involvement of muscular sphincteral structures, which is useful information to plan the most appropriate medical or surgical treatment. As for traumas, anal US is also a useful tool for identifying sphincteral injuries secondary to blunt trauma and for following-up sphincteral reconstruction with graciloplasty. Twenty-two patients with suspected sphincteric trauma were examined and anal US showed a sphincteral injury in 7 of 13 patients with acute postpartum-related symptoms; the clinical picture was ascribed to postpartum stretching of the pudendal nerve in 6 other patients. Finally, this method can be very useful in the follow-up of anal diseases, both to study surgical drainages and in the postoperative study of anal fistulae.
Anal Canal↗
Presence of serotonin1A (5-HT1A) receptor mRNA without binding of [3H]-8-OH-DPAT in peripheral blood mononuclear cells.
The authors investigated the presence of serotonin receptor type 1A (5-HT1A) as labeled by the specific ligand 3H-8 hydroxy-2-(di-N-propylamino)tetralin (3H-8-OH-DPAT) in saturation experiments, and the expression of the mRNA encoding them, in human peripheral blood mononuclear cells (PBMC). In situ hybridization experiments were performed as well. The results, showing that the binding of [3H]-8-OH-DPAT to lymphocyte membranes increased linearly up to 100 nM without reaching saturation, may indicate that the 3H-8-OH-DPAT was not specifically labeling the 5-HT1A receptor. By contrast, the expression studies revealed 5-HT1A mRNA in PBMC. These findings suggest that, despite the presence of mRNA, 5-HT1A receptors are not expressed in PBMC, at least in healthy controls.
8-Hydroxy-2-(di-n-propylamino)tetralin↗
[The Ellis-van Creveld syndrome. A case report].
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Bone and Bones↗
Correlative morphologic and functional imaging for diagnosis, staging and follow up in AIDS: an overview.
The immunocompromised patient can be affected by different opportunistic infections and tumors, that can involve all organ systems, and particularly, the central nervous system, the respiratory system, the gastrointestinal tract. The extreme variability of AIDS presentations requires a specific preparation and cooperation between the different diagnostic imaging specialists and a close collaboration with the clinicians. With AIDS, different morphologic and functional imaging techniques can be used for detection of disease sites, assessment of the extent of the disease and monitoring of disease changes over time and response to treatment. The complexity of AIDS presentations is such that full integration of the complementary information obtained with different techniques could be most useful. Image registration (coregistration, fusion) indicates approaches where precise spatial cross-references are obtained, in order to combine the information acquired with different imaging modalities, in particular by blending morphologic CT/MRI data with functional SPET/PET data. In this paper, an overview of the developments in the field of "image fusion" follows some comments on the results of morphologic and functional assessment of brain, chest and abdominal diseases in the course of AIDS, as illustrative examples of the potential benefits of multimodality image correlation.
AIDS-Related Opportunistic Infections↗
["Uncompensated" small bowel obstruction in adults. Ultrasonographic findings of free fluid between loops and its prognostic value].
Plain abdominal film is the method of choice in the assessment of intestinal obstruction. This technique exhibits some limitations and must be frequently correlated with other diagnostic tools. Of them, US has been recently reported to allow the morphofunctional study of intestinal loops with high accuracy. Nevertheless, the literature on the usefulness of US disregards a sign of great interest, i.e., extraluminal fluid between bowel loops. Our personal experience in 56 adult patients with surgically confirmed small bowel obstruction suggests that this findings, demonstrated by US in 43 patients (73%), identifies early intestinal wall damage with high sensitivity. US, depicting fluid between bowel loops, can distinguish the various stages of obstruction, with major consequences on clinical management. US and plain abdominal film findings allowed us to distinguish three stages of obstruction: simple obstruction (15/56 patients, 27%), uncompensated obstruction (26/56 patients, 46%), and complicated obstruction (15/56 patients, 27%). These three evolutive stages exhibit different severity and require different surgical approaches.
Adult↗
[Endoanal ultrasonography, defecography, and enema of the colon in the radiologic study of incontinence].
In the last 3 years, the authors examined 564 patients with disturbed anorectal function. Of 41 incontinent subject in this series, 30 were retrospectively analyzed to assess the diagnostic contribution of double contrast barium enema, defecography and endoanal sonography. The authors propose a classification of fecal incontinence based on imaging findings: indeed, rectal incontinence can be distinguished from pelvic and sphincteral incontinence. Large bowel enema and defecography are the examinations of choice if rectal incontinence is suspected on the basis of clinical history and possible endoscopic, manometric and electromyographic findings. Defecography is suggested if pelvic incontinence is suspected, while anal endosonography is the exam of choice in case of suspected sphincteral incontinence. Especially thanks to the recent availability of the latter technique, today radiologists can directly visualize the anal sphincteral apparatus and its lesions, yielding objective evidence of this type of incontinence too. The authors report on both limitations and indications of each diagnostic method and conclude by stressing the fundamental role diagnostic imaging plays today in the study of this disorder.
Adult↗
[Classification, significance and sequelae of posttraumatic "occult" bone and cartilage fractures of the knee. The role of magnetic resonance].
Magnetic Resonance Imaging (MRI) shows, in the post-traumatic knee, a fairly high number of bone and cartilage injuries missed by conventional radiography and therefore called occult. Our aim is to classify these injuries, to correlate their site and distribution with associated menisco-ligamentous injuries and with trauma mechanisms. Thirty-eight patients with a history of acute knee trauma and negative X-ray findings were examined with MRI within 15 days of trauma. 1.5- and 0.5-T units and SE T1-weighted GE T2*-weighted and SE T2-weighted sequences were used. The injuries were classified as intraosseous and osteochondral bruises or fractures. Twenty-three patients with menisco-ligamentous injuries were submitted to therapeutic arthroscopy; the sites of bone and cartilage injuries depicted with MRI were studied with arthroscopy. Seven patients were followed-up with MRI at 6-12 months to investigate subchondral injury evolution: 5 of 7 patients were also submitted to arthroscopy. MRI showed a statistically significant correlation between site and distribution of bone and cartilage injuries and between internal derangement and trauma mechanisms, i.e., contusion, distortion, stress. In our experience, MRI could identify and characterize occult subchondral injuries, thus allowing appropriate treatment.
Adolescent↗
Localization and gene expression of serotonin 1A (5HT1A) receptors in human brain postmortem.
We investigated the binding parameters, i.e. the maximum binding capacity (Bmax) and the dissociation constant (Kd), of [3H]8-hydroxy-2-(di-N-propylamino)tetralin ([3H]8-OH-DPAT) labeling the serotonin receptor of the 1A type (5HT1A), and the distribution of the mRNA encoding it in some human brain areas obtained from autoptic samples. The results showed that the Bmax was significantly higher in the hippocampus than in the prefrontal cortex and the striatum, while the Kd had the inverse, although not significant, pattern. The expression study revealed that 5HT1A mRNA distribution in the hippocampus and prefrontal cortex was consistent with the data of the [3H]8-OH-DPAT binding. A different result was obtained in the striatum where no 5HT1A mRNA expression was detected, despite the measurement of specific [3H]8-OH-DPAT binding. These findings underline the different nature of [3H]8-OH-DPAT binding sites in different brain areas and the need for further studies on 5HT receptor gene expression in human brain.
Aged↗
Solubilization and characterization of [3H]imipramine and [3H]paroxetine binding sites from calf striatum.
The serotonin (5-HT) transporter from calf striatum cerebral membranes was solubilized with digitonin and characterized by gel exclusion chromatography. [3H]Imipramine and [3H]paroxetine were utilized as markers for labeling it. 3H-imipramine labels a high- and a low-affinity site on striatum membranes, whereas it binds to a single high-affinity site on the solubilized fraction. [3H]Paroxetine binds with the same affinity to a single site on both membranes and solubilized preparations. After gel exclusion chromatography of the solubilizate both [3H]imipramine and [3H]paroxetine bind on an identical fraction of 205 kDa molecular weight, with a similar maximum number of binding sites (Bmax). Our results suggest that both 3H-imipramine and [3H]paroxetine bind to a common site on the 5-HT transporter.
Animals↗
Changes in peripheral benzodiazepine receptors in patients with panic disorder and obsessive-compulsive disorder.
Peripheral benzodiazepine (BDZ) receptors were investigated through the binding of the specific ligand 3H-PK-11195 to platelet membranes, in 17 patients suffering from panic disorder (PD) and in 16 patients affected by obsessive-compulsive disorder (OCD). The results, showing that the density (Bmax) of peripheral BDZ receptors was significantly lower in patients with PD than in controls or OC patients, suggest that the number of platelet BDZ receptors varies with different anxiety disorders and that perhaps this marker may be beneficial in differentiating some subtypes of these disorders.
Adolescent↗
[High resolution computerized tomography in the study of the lung parenchyma. Possibility of a low-dose protocol].
High-resolution CT (HRCT) is a useful technique to investigate minimal diffuse lung disease. Two major limitations of HRCT are the higher radiation dose to the patient than in conventional CT of the chest and therefore the impossibility to study the lungs completely. These limitations can be partially overcome by using a low-dose protocol with mAs reduction. In our preliminary experience on 19 patients affected with various lung diseases, the low-dose protocol exhibited poorer image quality but almost equivalent anatomical detailing; the diagnostic yield was higher than that of conventional HRCT. Thus, in our experience, low-dose HRCT makes an interesting compromise in the study of lung parenchyma.
Adult↗
[Diagnosis of free air in the abdomen. Role of echography].
Pneumoperitoneum secondary to gastrointestinal tract perforation is usually detected with plain abdominal films. Even when the examination cannot be performed in the upright position, free abdominal gas can be demonstrated with the accurate evaluation of supine radiographs. Some literature studies showed the value of ultrasonography and its higher diagnostic yield than that of plain abdominal films. However, in our experience on a series of 37 patients with surgically confirmed post-perforative pneumoperitoneum who underwent US first and radiography second, US had lower sensitivity than radiography (76% vs 92%, respectively). This was only partially compensated for by the detection of other signs and by better etiologic orientation. Therefore, we believe plain abdominal films to be still the method of choice to study the patients with suspected gastrointestinal perforation. Thus, US should be used in selected cases only--i.e., clinical conditions preventing radiographs from being performed correctly, persisting clinical suspicion with negative or questionable radiographic findings, the exclusion of other acute abdominal conditions, and finally the presence of pneumoperitoneum in the patients referred for different clinical reasons.
Adult↗
[Videoproctography in the study of rectal intussusception. The authors' own experience].
Videoproctography has proved to be a useful diagnostic technique to investigate anorectal disorders; it can provide morphological and functional information which no other diagnostic method yields. From a series of 898 videoproctographs, the findings of 117 patients with rectal intussusception were retrospectively reviewed. The most common symptoms were an incomplete emptying feeling (93% of cases), obstructed defecation (78%), and a feeling of upright rectal weighting (71%). Of the three known types of rectal intussusception, the most common type was distal intussusception (44%), followed by the rectoanal type (38%) and finally by the proximal type (19%). The three types of intussusception were frequently (42%) associated with other disorders of rectal ampulla and especially with rectocele (15%), mucosal prolapse (8%), and descending perineum syndrome (12%); they had different clinical correlations and proctographic patterns and could be recognized in different defecation phases. In our personal experience, proctography with videorecording was a useful diagnostic tool in the dynamic assessment of this morphofunctional disorder which represents one of its major indications.
Adult↗
[Dynamic single-slice computed tomography in the pretreatment evaluation of hepatocarcinoma in cirrhosis].
Hepatocellular carcinomas (HCCs) are currently treated with surgery, transcatheter chemoembolization and percutaneous alcoholization; all methods require accurate in vivo anatomopathology of the lesion. The authors report their personal experience with 58 HCCs on cirrhosis which were studied with dynamic single-slice CT after the injection of water-soluble iodate contrast medium with automatic injector in a peripheral vein. Three semiologic patterns were identified according to lesion density on pre- and post-contrast images. The active portion of the lesion could be differentiated from the necrotic one in 100% of cases. Moreover, the necrotic lesion was differentiated from possible still viable tumor portions but with vacuolar degeneration phenomena. These findings allowed the authors to calculate the growth rate and the infiltrative capability of the single neoplastic masses. Finally, the dynamic evaluation of parenchymal enhancement allowed abnormal tissue vascularization due to arterioportal communication to be demonstrated in 7 cases. The authors conclude the dynamic single-slice CT allows the accurate assessment of HCC foci, of tumor tissue vascularization and of perilesional liver parenchyma. Therefore, dynamic single-slice CT is suggested as the technique of choice to study small HCCs before treatment.
Adult↗
[Biliary ileus of the sigmoid: its echographic diagnosis. A case report].
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Aged↗
Age-related changes in peripheral benzodiazepine receptors of human platelets.
Using 3H-PK 11195 as radioligand, the number and affinity of peripheral benzodiazepine receptors in platelets of 15 elderly healthy subjects were compared to those of 15 young subjects. The results showed that the dissociation constant (Kd) was significantly higher in the elderly than in the young subjects, while the density of binding sites did not differ. These findings suggest that the age-related changes in peripheral benzodiazepine receptors may be coupled with secondary changes in their hypothesized functions.
Adult↗