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Biomedical subjects

F Nobili

Publications and source records attributed to F Nobili.

At least 91 records · Page 5Linked to original sources
PubMed1991

Spinal cord stimulation and cerebral haemodynamics.

An increase of regional cerebral blood flow (rCBF) has been shown to occur in man during spinal cord stimulation (SCS) by Hosobuchi (1986) and by Meglio et al. (1988) using the 133-Xenon wash-out technique. In this paper we report the effects of SCS on CBF as measured by two different techniques: 8 patients were studied with the 133-Xe method and 28 with the transcranial doppler sonography (TCD), in two cases both studies were performed. The aim of our study was to: 1-verify the effect of SCS on CBF, 2-compare observations made by two different methods, and 3-evaluate a possible correlation between the stimulated spinal segmental level and the modification of CBF. The results of our study confirm that SCS interacts with the mechanisms of regulation of CBF. The stimulation of different spinal cord levels in the same patient can produce different effects and such effects are reproducible. An increase of CBF is more likely to occur with the stimulation of the cervical spinal cord. In patients studied by both methods the sign of CBF changes induced by SCS was the same. Finally, in two patients the effect of SCS on CO2 autoregulation was studied with TCD. The results of such a study, although preliminary, suggest that CO2 and SCS have a competitive effect upon the mechanisms of regulation of CBF.

Blood Flow Velocity↗
PubMed1991

CBF side-to-side asymmetries in stenosis-occlusion of internal carotid artery. Relevance of CT findings and collateral supply.

Cerebral blood flow (CBF) was studied at rest by 133-Xenon inhalation method in 15 normal subjects, in 10 patients with cerebral infarction and normal angiograms of major cerebral arteries and in 28 patients with unilateral stenosis-occlusion of the internal carotid artery (ICA), with or without cerebral infarction. All the normals and 20 patients with ICA stenosis-occlusion were tested again after cerebral vasodilatation induced by an intravenous bolus of acetazolamide. At rest the patients with cerebral infarction, irrespective of whether ICa stenosis-occlusion was present or not, showed abnormal side-to-side CBF asymmetry. After cerebral vasodilation variations in side-to-side asymmetry were shown to depend on the inefficiency of the collaterals and not on the degree of ICA obstruction or on the presence of cerebral infarction. These data indicate that at rest side-to-side CBF distribution is influenced more by the presence of an ischemic zone than by a ICA stenosis-occlusion and that under these circumstances the hemodynamic effect of the vascular stenosis cannot be assessed. After cerebral vasodilatation a subset of patients--irrespective of the degree of ICA obstruction and of whether or not cerebral infarction is present--with true cerebrovascular insufficiency can be isolated.

Acetazolamide↗
PubMed1991

Brain functional imaging in senile psychopathology.

Quantified electroencephalogram (EEG) and regional cerebral blood flow (rCBF) measurements are reliable and currently employed techniques in the functional exploration of the aging brain; they can be routinely employed, since discomfort to the patient is minimal. Topographical analysis of EEG and rCBF results is performed in our laboratory by a fully automated mapping system, which also enables statistical comparisons in real time. The goal of our study is to ascertain if there are systematic modifications in the topographic distribution of rCBF and EEG parameters in normal aging, dementia, cerebrovascular disease and in conditions of increased risk for cerebral pathology (e.g. hypertension). Dementias and cerebrovascular pathologies present characteristic brain functional abnormalities, which can be detected by comparing the patient data to an age-matched normal population by the appropriate statistical tests; therefore, the accurate selection of healthy aged controls appears as a crucial issue in order to improve the sensitivity of statistics.

Adult↗
PubMed1991

Judo and choking: EEG and regional cerebral blood flow findings.

Ten judoka were examined at rest by EEG and regional Cerebral Blood Flow (rCBF) (133-Xenon inhalation method); in seven of them a syncope was induced by choking and EEG was recorded during the loss of consciousness while rCBF was measured immediately after recovery. Baseline EEG and rCBF examinations were normal. During choking, EEG showed diffuse 2-3 Hz. high voltage waves, predominantly in the anterior regions, then the EEG gradually recovered to normal. After choking, rCBF decreased in all but one subject, slightly in four and more markedly in two. Our findings suggest that there is no evidence of permanent CNS functional changes due to judo practice and choking. The variable rCBF features soon after choking-induced syncope may reflect a different timing of recovery from cerebral ischemia for each subject.

Adolescent↗
PubMed1991

High-pressure hemarthrosis: possible consequences to the vascularization of the femoral head.

The authors both detected hemarthrosis and calculated intraarticular pressure and blood supply to the femoral head using diagnostic tests (ultrasound, arthrography, manometric measurements, and bone scan tomography) in 18 patients with femoral neck fracture. The data obtained, in agreement with other reports in the literature, show a relationship between the condition of the joint capsule, the level of intraarticular pressure, and the arterial blood supply to the femoral head in cases of undisplaced or slightly displaced femoral neck fracture. The potential clinical implications are discussed.

Aged↗
PubMed1991

Cervical stump carcinoma therapy.

59 patients with cervical stump cancer were reviewed. A distinction was made between true and coincident cancer. Histological features, therapeutic plan and survival rates are reported. In stage I treatment was mainly surgical, while in more advanced stages radiation therapy was applied. In 22.2% of cases combined surgical-radiation therapy was performed. The absolute 5-year survival for various clinical stages is as follows: stage I, 88.2%; stage II, 53.8%; stage III, 42.8%; stage IV, 0.0%. The overall absolute 5-year survival rate for all stages combined is 60.9%. Individualization of therapy can offer to the patient with cervical stump carcinoma a survival similar to the patient with cervical neoplasm with intact uterus.

Adenocarcinoma↗
PubMed1990

An atypical paediatric case of malignant atrophic papulosis (Köhlmeier-Degos disease).

A new case of malignant atrophic papulosis (Köhlmeier-Degos disease) is reported. Vascular symptoms began at 17 months of age with cerebral ischaemia and progressive involvement of fingers and toes with torpid ulcers and apical necrotic amputations. At 6 years of age he developed chronic intestinal ischaemia with malabsorption and a new cerebral attack; in spite of anti-aggregant therapy the disease progressed and he died 7 months after diagnosis from a third cerebral ictus. Since the typical skin lesions of the disease were absent, the diagnosis was made on the basis of a pathological pattern of an occluded biopsied artery. The elder brother presents clinical and instrumental vascular involvement without cutaneous lesions and could be slightly affected.

Arterial Occlusive Diseases↗
PubMed1990

Primary dysautonomia: cerebral blood flow and hemodynamic findings. Case report.

In a man with orthostatic and effort syncopes due to primary dysautonomia, we measured cerebral blood flow (CBF)--by the 133-Xenon inhalation method--in supine and in sitting positions, and after the i.v. administration of Acetazolamide, a potent cereal vasodilator. Heart rate (HR) and blood pressure (BP) were monitored over the 24 hours by a non-invasive device. The CBF was normal in supine position and significantly reduced when the patient was sitting. Despite che sympathetic denervation, good response to acetazolamide infusion was seen. BP changed with the position of the subject according to gravity, and HR was unresponsive to orthostatic and effort stimuli.

Acetazolamide↗
PubMed1990

Acute effects of acetyl-L-carnitine on regional cerebral blood flow in patients with brain ischaemia.

Ten male patients with brain ischaemia were studied. Regional cerebral blood flow (rCBF) was measured in the resting condition and 1 h after intravenous infusion of 1500 mg acetyl-L-carnitine. rCBF values were compared to those of a control population of the same age decade by a computer mapping system of our own design, which enables rapid visual inspection of cerebral blood flood values distribution and of statistical significance of differences. Beneficial effects of the drug were observed in at least four patients, especially in the affected hemisphere, in another four, rCBF elevations in the areas which were lowest on resting examination were observed, which was paralleled by reductions in surrounding zones. In two patients no modification of rCBF values after acetylcarnitine was seen.

Acetylcarnitine↗
PubMed1989

Cerebral blood flow and plasma free tryptophan in cirrhotics with and without hepatic encephalopathy.

Cerebral blood flow (CBF), measured by the non-invasive 133-Xenon inhalation method, plasma levels of ammonia (NH3) and free tryptophan (fTRP) were determined in 30 cirrhotic patients without overt encephalopathy. Psychometric evaluation detected subclinical hepatic encephalopathy (SHE) in 20 of them, and was normal in the other 10. A significant CBF difference (p less than 0.05) was found between the SHE and the non-SHE patients. fTRP levels were significantly (p less than 0.05) higher in patients with SHE than in those without SHE, and a significant negative correlation (p = 0.003) was found between CBF values and fTRP in the whole group of patients. NH3 did not differ in the two subgroups and did not correlate with CBF values. It is concluded that CBF could have some implications in SHE, although its relevance is still unclear. The negative correlation between CBF and fTRP prompts further investigation concerning the relationships between plasma fTRP, brain serotonin, cerebral metabolism and blood flow in the development of brain derangement during cirrhosis.

Adult↗
PubMed1989

Regional cerebral blood flow and anxiety: a correlation study in neurologically normal patients.

Regional CBF (rCBF) was evaluated by the 133Xe inhalation method in 60 neurologically normal patients (30 men and 30 women) and hemispheric and regional values were correlated with anxiety measurements collected by a self-rating questionnaire before and after the examination. Statistically significant negative correlations between rCBF and anxiety measures were found. rCBF reduction for high anxiety levels is in line with results previously reported by others and could be related to lower performance levels for moderately high anxiety scores as those reported in the present population. This could perhaps be explained by rearrangement of flow from cortical zones to deeper areas of the brain, classically known to be implicated in the control of emotions. However, these results should be interpreted cautiously, since they were obtained in patients and not in normal subjects.

Adult↗
PubMed1989

Evaluation of cerebral blood flow data in stroke patients using a mapping system.

We retrospectively examined regional cerebral blood flow values in 78 patients in the stabilized phase of stroke to evaluate the consistency of lateralization compared with computed tomographic imaging. Examinations were performed using the xenon-133 inhalation technique, and the data were processed and displayed by a computer-assisted system of our own design that allows statistical analysis in real time and is suitable for clinical use. The consistency of lateralization correlated with computed tomographic findings was tested for absolute values, percent distribution, and asymmetries. The latter yielded the highest degree of sensitivity (in 83.3% of the patients the affected hemisphere was correctly identified). Absolute values showed at least one hypoperfused area in the affected hemisphere in 48.7% of the patients, and percent distribution did so in 57.7%. Furthermore, the combination of the three methods of data analysis yielded a sensitivity of 91%; the remaining 9% of the patients, however, exhibited some abnormalities of regional cerebral blood flow (bilateral or contralateral hypoperfusion). Although good agreement was found for lateralization by computed tomography and by the combined use of the three methods of analysis, a complete overlap between functional and structural examinations should not be expected. Problems concerning the sensitivity of the xenon-133 inhalation technique under conditions of low blood flow and the statistical analysis of regional cerebral blood flow data are discussed.

Administration, Inhalation↗
PubMed1989

The viral lesion (HPV) of the lower genital tract in teen agers: clinical and therapeutic aspects.

From January 1985 to July 1987, 116 adolescents affected by the lesions of the lower genital tract (Human Papilloma Virus +/- Intraepithelial Neoplasia) came to the laser surgery service of the 2nd Department of the Obstetric and Gynecologic Clinic of the University of Rome "La Sapienza" for the treatment of the lesions. The patients were examined also from the epidemiologic point of view and sides effects of the treatment were evaluated. A cure rate of 92% is certainly a significant value, especially considering the higher frequency of recurrence at the vulvovaginal level.

Adolescent↗
PubMed1987

Reduction of cerebral blood flow in subclinical hepatic encephalopathy and its correlation with plasma-free tryptophan.

Cerebral blood flow (CBF), measured by the noninvasive xenon-133 inhalation method, EEG, and plasma levels of ammonia (NH3) and free tryptophan were determined in 18 hospitalized cirrhotic patients affected with subclinical hepatic encephalopathy, as diagnosed by the Kurtz test. CBF results were significantly lower (p less than 0.001) in the patients' group as compared with a sex- and age-matched normal control population, although seven patients had values in the normal range. NH3 was increased only in six, while free tryptophan was increased in all but two patients. A significant negative correlation (p = 0.02) between CBF and free tryptophan was found, even though it appears to be difficult to interpret. We suggest that CBF impairment in some cirrhotic patients with subclinical hepatic encephalopathy may be related to the systemic metabolic derangement caused by the liver disease; free tryptophan could have some implication in producing CBF reduction.

Adult↗