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Biomedical subjects

A Tognetti

Publications and source records attributed to A Tognetti.

At least 19 recordsLinked to original sources
PubMed2004

Artificial kinesthetic systems for telerehabilitation.

Artificial sensory motor systems are now under development in a truly wearable form using an innovative technology based on electroactive polymers. The integration of electroactive polymeric materials into wearable garments endorses them with strain sensing and mechanical actuation properties. The methodology underlying the design of haptic garments has necessarily to rely on knowledge of biological perceptual and motor processes which is, however, scattered and fragmented. Notwithstanding, the combined use of new polymeric electroactive materials in the form of fibers and fabrics with emerging concepts of biomimetic nature in sensor data analysis, pseudomuscular actuator control and biomechanical design may not only provide new avenues toward the realization of truly wearable kinesthetic and haptic interfaces, but also clues and instruments to better comprehend human manipulative and gestual functions. In this talk the conception, early stage implementation and preliminary testing of a fabric-based wearable interface endowed with spatially redundant strain sensing and distributed actuation are illustrated with reference to a wearable upper limb artificial kinesthesia system, intended to be used in telerehabilitation of post stroke patient.

Clothing↗
PubMed2004

Strain sensing fabric for hand posture and gesture monitoring.

Monitoring body kinematics and analyzing posture and gesture is an area of major importance in bioengineering and several other connected disciplines such as rehabilitation, sport medicine and ergonomics. Recent developments of new smart materials consent the realization of a new generation of garments with distributed sensors. What we present here is a sensing glove able to detect the posture and movements of the hand.

Biomechanical Phenomena↗
PubMed2002

Rare case of inflammatory fibrous polyp of the esophagus.

Esophageal inflammatory fibrous polyps are extremely rare benign neoplasms. The manuscript illustrates a case of a man complaining of pyrosis and gastroesophageal reflux symptoms. Diagnostic work-up showed an expansive lesion of the distal esophagus simulating malignancy but with negative, repeated, multiple biopsies. The considerable size of the lesion, and the suspicion of a malignant tumor because of the presence of ulceration, indicated esophagectomy with extensive lymphadenectomy and intrathoracic esophagogastroplasty. The diagnosis of inflammatory polyp of the esophagus was achieved postoperatively. The Discussion deals with a review of the literature and considers the performed operation a good choice considering the hypothesis of a malign neoplastic evolution of this lesion.

Esophageal Neoplasms↗
PubMed2002

Churg-Strauss syndrome: clinical and serological features of 19 patients from a single Italian centre.

OBJECTIVE: Churg-Strauss syndrome is a rare multisystem vasculitis of unknown aetiology. Due to the rarity of the disease, few single-centre case series have been described. The aim of this study was to evaluate a small series from a single Italian centre in order to describe the clinical features of the disease, the treatment and long-term follow-up. METHODS: Nineteen Churg-Strauss syndrome patients were selected from the medical records of all vasculitis patients attending the Immunology Unit at the Department of Internal Medicine of the University of Pisa in the decade between 1989 and 2000. Data were obtained retrospectively. RESULTS: All the patients had asthma and hypereosinophilia. As in other case series, the lungs, skin and peripheral nervous system were the most commonly involved organs. The majority of our patient received i.v. pulses of methylprednisolone followed by i.v. pulses of cyclophosphamide. The outcome and long-term follow-up were good. There were no fatalities observed in this series during the follow-up period. CONCLUSIONS: Churg-Strauss syndrome is a systemic vasculitis occurring in patients with a history of asthma and allergic rhinitis. The positive results of the treatment protocol used in this preliminary study deserve to be tested in controlled multicentre studies.

Adult↗
PubMed1998

Behçet's disease with gastrointestinal involvement associated with myelodysplasia in a patient with congenital panhypopituitarism.

Myelodysplastic syndromes (MDS) are hematologic disorders characterised by peripheral cytopenias and the hystologic features of hematologic dysplasia. Their association with autoimmune manifestations have been suggested by several authors: recently, the appearance of Behçet's disease during MDS has been reported. We describe the occurrence of MDS in a patient affected by Behçet's syndrome with gastrointestinal involvement and congenital panhypopituitarism.

Behcet Syndrome↗
PubMed1998

Bladder involvement in systemic sclerosis: urodynamic and histological evaluation in 23 patients.

Lower tract involvement of systemic sclerosis is an uncommon manifestation. In this study we have evaluated the functional and morphologic vesical changes in 23 female patients with systemic sclerosis to investigate if bladder dysfunction was correlated with an extended skin sclerosis and/or a more serious organ involvement. Urodynamic alterations were observed in only 3 cases. Urinary symptoms and urodynamic features were correlated neither with severity of vesical fibrosis nor with visceral involvement. Autonomic dysfunction was detected in 13 patients.

Adult↗
PubMed1998

[Significance of three-compartment digitalized arthrography in the diagnosis of post-traumatic instability of the radiocarpal complex].

INTRODUCTION: The radiocarpal complex is the structure formed by the distal radioulnar, radiocarpal and midcarpal joints; these joints are compartments, each anatomically separated from the other. An appropriate arthrographic study with three-compartment injection better demonstrates the capsuloligamentous structures than conventional radiography. The diagnosis of any condition in this complex may therefore be easier to make. MATERIAL AND METHODS: From January 1993 to December 1996, twenty-six patients with mild to moderate wrist and carpal sprain and previously examined with radiography, were submitted to digital three-compartment arthrography at the Imaging Diagnostic Service of the Rizzoli Orthopedic Institute. Of 17 patients with previous radiographic diagnosis of scapholunar diastasis, 1 patient had a negative radiographic picture, 15 had an incomplete tear of the scapholunar ligament and 1 a double injury of the scapholunar and triquetro-lunar ligaments. Of 10 patients with mild to moderate triquetro-lunar diastasis, 8 had and arthrographic picture of pyramido-lunar ligament injury, 1 had a double injury of the triquetro-lunar and scapholunar ligaments and another one of triangular fibrocartilage complex injury. RESULTS: Three-compartment contrast agent injection permitted the diagnosis of interruptions between the different compartments and more injuries of scapholunar and triquetro-lunar ligaments than single compartment injection. We examined 27 patients with small arch injuries with three-compartment digital arthrography and found scapholunar diastasis in 17 (63%) and triquetro-lunar diastasis in 10 (37%). In the first group of 17 patients, three-compartment arthography demonstrated more scapholunar ligament injuries (13 cases) than single compartment injection; image subtraction, allowed by the digital technique, showed 2 injuries not visible otherwise. Injuries of the scapholunar and triquetro-lunar ligaments were demonstrated with and without digital subtraction. One patient had no ligament injury. In the other group of 10 patients, three-compartment arthrography showed more triquetro-lunar ligament injuries (6 cases) than single compartment injection; image subtraction demonstrated 2 injuries not visible otherwise in this group too. Injuries of the scapholunar and triquetro-lunar ligaments were demonstrated with and without digital subtraction. The injury of triangular fibrocartilage and contrast agent leak into soft tissues were shown in one patient with the injection of the distal radioulnar compartment alone, regardless of image subtraction. CONCLUSIONS: Arthrography, combined with conventional static and dynamic radiography, increases the detection rate of capsuloligament joint defects in the wrist-carpal complex. The three-compartment digital technique combines the advantages of fluoroscopic monitoring and videorecording and allows real time imaging of the contrast agent flow during injection in different compartments. Moreover, the digital technique permits the complete study of all joints in a single session, while image subtraction reveals even minimal ligament changes. This technique becomes therefore a fundamental tool for surgical planning.

Adult↗
PubMed1998

[Significance of computerized tomography in the diagnosis of post-traumatic proximal carpal instability].

INTRODUCTION: Proximal carpal instability is a painful condition characterized by early or late loss of radioulnar joint (RUJ) congruence not affecting the normal bone alignment of the two carpal rows. The joint incongruence or (incomplete) dislocation which leads to proximal instability is caused by many traumatic and nontraumatic events. The diagnosis of (incomplete) dislocation of the distal RUJ may be extremely difficult to make at conventional radiography because such injuries can be seen only when the lateral joint projection is perfect; otherwise the diagnosis is not reliable. CT is the only imaging tool diagnosing the grade of distal RUJ congruence independent of the examination technique. MATERIAL AND METHODS: We studied the radiocarpal complex conditions leading to proximal instability at the Rizzoli Orthopedic Institute from December, 1995, through December, 1997. In all, 389 cases were seen, 376 from trauma and 13 of nontraumatic origin. Each injury was studied with conventional radiography, CT, and MRI. Radiography was performed in two projections, namely the posteroanterior one with hand extension and the lateral one with the forearm in neutral position and the elbow bent at 90 degrees; the projections were repeated whenever a cast brace was applied. Unenhanced CT was performed for comparison with the patient prone and the forearm and wrist in prone and neutral position, as well as with the patient, forearm and wrist supine. Three criteria of electronic image processing were adopted for the RUJ studies in the 3 projections: radioulnar lines, congruence, and epicenter. MRI was always performed after conventional radiography and CT. Only the involved radiocarpal region was studied; coronal, axial and sagittal images were acquired with T2-weighted GE and T1-weighted SE sequences. RESULTS: Proximal instability was found in 17 of 389 patients; it was early in 13 and late in 4 of them. The comparison of radiographic and CT results showed that the former method is unreliable, with 53% false negatives. Pain, a cast brace, congenital or acquired deformities of distal radius and ulna and patient mispositioning by the radiology technician can change the rotation of the forearm, wrist and hand and make a perfect laterolateral projection in neutral position unfeasible, which affects the radiographic diagnosis. Conversely, CT showed its extreme efficacy in assessing the distal RUJ congruence with no false negatives independent of the RUJ rotation and of instability type and grade. CONCLUSIONS: Conventional radiography is a poorly reliable tool for the diagnosis of joint incongruence and its grade. In contrast, CT can diagnose a RUJ (incomplete) dislocation easily and unquestionably, thanks to its axial capabilities, even when adequate radiographic studies would be unfeasible. If the anteroposterior projection of the radiocarpal complex shows a congenital or acquired deformity of distal radius, the lateral projection can be skipped and a CT scan in prone, neutral and supine position performed. The 3 CT criteria quantify incongruence type and grade, and also demonstrate the position of maximum incongruence and its decrease by position. The comparative study of the radiocarpal region makes CT a very useful and valuable tool in congenital instability because its allows the assessment of contralateral radioulnar congruence too. MRI is very useful in the diagnosis of injury or degeneration of the fibrocartilage complex, namely in patients with no bone changes at conventional radiography.

Humans↗
PubMed1997

[Traditional radiology in the assessment of posttraumatic carpal instability].

INTRODUCTION: Carpal instability is a painful posttraumatic syndrome with early or late loss of the normal alignment of the carpal bones, which can be caused by a variety of injuries, from minor sprain to major fracture-dislocation of the carpal-wrist complex. If the trauma causing instability is a fracture, a severe dislocation or a fracture-dislocation, the radiographic diagnosis is not particularly difficult. The morphologic and dynamic complexity of the carpal region represents, instead, a major obstacle in the radiologic diagnosis of mild or moderate sprains because the morphologic alterations on standard static views are minimal or absent in these conditions. MATERIALS AND METHODS: We reviewed 214 injuries causing posttraumatic carpal instability including both the cases classified by the Data Analysis Center of the Istituto Ortopedico Rizzoli as carpal dislocations and fracture-dislocations from January, 1975, to July, 1996, and the more recent cases directly observed at our Casualty Clinic. In the former cases, we reviewed only the available images, while our patients were examined with comparative standard and under stress or dynamic views. RESULTS: Of 214 lesions causing posttraumatic carpal instability, 43 along the great arch were classified as severe because they were easily detectable on standard films and 171 along the small arch were classified as mild because slight/no abnormalities were detected on standard static views. Only dynamic imaging showed posttraumatic carpal instability demonstrating the integrity of the ligaments and of the carpal hinges, as well as gaps or asymmetry not detected on static views. CONCLUSIONS: We suggest the systematic use of dynamic imaging in the cases where static findings are negative or poor, in the patients with a painful wrist after an apparently minor sprain. Missed or delayed diagnoses are thus reduced, as well as the consequent joint incongruity and/or chronic subluxation which may severely impair these patients.

Carpal Bones↗
PubMed1996

[Anatomopathology, computerized tomography, and magnetic resonance correlations in soft tissue liposarcoma].

Liposarcomas are one of the most common soft tissue malignant tumors; they can be differentiated in four histologic subtypes: well-differentiated, myxoid, round cell and pleomorphic liposarcomas. The search of differential CT and MR patterns to better classify the lesions in the proper histologic subtype is justified by the different histologic features, clinical course and especially prognosis, of every lesion subtype. From 1990 to 1995, 50 liposarcoma patients were examined preoperatively with CT and MRI in our Institute of Radiology. We found 7 well-differentiated liposarcomas (14%), twenty myxoid liposarcomas (40%), ten round cell liposarcomas (20%) and, finally, 13 pleomorphic liposarcomas (26%). The thigh was the most common tumor site (60%). The following parameters were considered: lesion margins, tissue homogeneity, fat tissue ratio and the presence of calcifications. Well-differentiated liposarcomas presented well-defined and regular margins (72%), mildly heterogeneous appearance (44%) and more than 75% fat tissue (72%). Myxoid liposarcomas presented well-defined and regular margins (65%), heterogeneous appearance (65%) and less than 25% fat tissue (95%). The diagnosis of myxoid liposarcoma can be made in the presence of myxoid tissue, which has very low CT attenuation values and mildly hypointense signal on T1-weighted and progressively hyperintense signal on T2-weighted MR images. Round cell and pleomorphic liposarcomas are high-grade malignancies and they cannot be distinguished from other malignant soft tissue lesions. In these cases, the diagnosis can be made only at histology.

Adult↗
PubMed1990

Linear and non-linear relationships between the 'swelling test' and conventional semen variables in men suspected of primary infertility.

The relationship and degree of association between the percentage of sperm swelling (HOS-test) and conventional semen variables was investigated in 263 consecutive ejaculates. The semen samples were exclusively obtained from men suspected of primary infertility. It was found that the correlation coefficients (Spearman's rho) followed the order: percentage of progressive motility at 3 h greater than count/ml greater than percentage of total motility at 3 h greater than percentage of normal spermatozoa. Of the three morphology sub-classes considered (sperm head, mid-piece and tail abnormalities), only mid-piece abnormalities correlated with the outcome of the HOS-test (rho = -0.409). Linear relationships between HOS-test results and sperm motility and morphology, but not sperm count, were indicated by LOWESS-smoothing. However, a linear relationship between the HOS-test, sperm count and a 'functional index' combining the conventional semen variables could be demonstrated after normalization of the data. Our findings suggest that the HOS-test may be of value in assessing the functional integrity and viability of spermatozoa; however, its prognostic power for fertility is probably not different from that of conventional semen variables.

Fertilization↗
PubMed1976

Effect of metergoline, a specific serotonin antagonist, on human growth hormone response to arginine and L-dopa.

In seven normal subjects the repeated oral administration of metergoline, a specific antiserotonin agent, has enhanced HGH response to arginine infusion. Following placebo administration, arginine-induced HGH release was slightly but not significantly reduced; similarly, in eight metergoline treated subjects, HGH response to oral L-Dopa was slightly but not significantly reduced. HGH response to i.v. L-Dopa was not modified by the drug. These results suggest that serotonin controls HGH response only in response to arginine, not to L-Dopa.

Adolescent↗
PubMed1975

Effect of metergoline, a powerful and long-acting antiserotoninergic agent, on insulin secretion in normal subjects and in patients with chemical diabetes.

The effect of metergoline on insulin secretion has been evaluated in normal subjects and in patients with chemical diabetes. The repeated administration of metergoline, 2 mg at four-hour intervals to give a total of 24 mg, has enhanced insulin secretion in response to i.v. glucose in normal subjects but not in chemical diabetics. No changes in blood glucose pattern were observed. Under similar conditions, metergoline administration caused a slight but significant decrease in arginine-induced insulin release, both in normal subjects and in chemical diabetics. These results support the concept of a serotoninergic control of insulin secretion and suggest that serotonin exerts different effects on insulin release according to the different stimuli.

Arginine↗