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Biomedical subjects

G Cerri

Publications and source records attributed to G Cerri.

18 recordsLinked to original sources

Motoneuronal pre-compensation for the low-pass filter characteristics of muscle. A quantitative appraisal in cat muscle units.

1. The relevance of motoneurone dynamic sensitivity in compensating for the low-pass filter properties of muscle was assessed by stimulating cat muscle units (MUs) with impulse discharges generated by two current-to-rate converters: (i) a spinal motoneurone, sensitive to both the input intensity and its first derivative, and (ii) a linear current-to-rate converter, i.e. a neurone model with the same static sensitivity as the motoneurone but lacking dynamic sensitivity. 2. Discharges generated by injection of sine-wave currents in three motoneurones of the 'fast' type and in the three related model versions were applied to the axon of forty-six MUs. The MU isometric tension was modulated at the frequency of the current sine wave (0.5-20 Hz). Phase and gain of the current-to-force transduction were measured. 3. When MUs were driven by the model, the force lagged the current by 90 deg at 1 Hz in slow MUs and at around 5 Hz in fast MUs. Under motoneurone drive, the 90 deg phase lag was attained at frequencies about twice as high. 4. The gain of the transduction (peak-to-peak force modulation/peak-to-peak current modulation) decayed when the modulation frequency was increased. In all but five units, the cut-off frequency, Fco (gain attenuated by -3 dB), was higher when the unit was motoneurone driven (FcoCell) then when it was model driven (FcoMod). In both conditions, Fco was inversely correlated with the MU's time-to-peak. The advantage conferred by the motoneurone dynamic sensitivity was expressed by the Fco ratio (FcoCell/FcoMod). Across the MU population this ratio ranged from 0. 6-2.8, was inversely correlated with the time-to peak, and was directly correlated with the half-tension rate, i.e. the impulse rate at which MUs develop 50 % of their maximal tetanic force. The largest improvement (Fco ratio > 2.0) was found in units with mechanical features similar to those presumably coupled 'in vivo' to the motoneurones utilized for stimulation. 5. This estimate was confirmed in experiments in which trains of pulses, generated by injection of ramp currents in another motoneurone and the related model, were used to activate eight MUs, selected for being similar to that connected 'in vivo' to the motoneurone. As expected, for any given current slope the rising phase of isometric tension was steeper when units were motoneurone driven than when they were model driven. The gain (force slope/current slope) was plotted against the ramp slope to identify the cut-off slope, Sco, at which the gain was attenuated by -3 dB. In this homogeneous MU sample, the ratio expressing the advantage of the motoneurone drive (ScoCell/ScoMod, equivalent to the Fco ratio), ranged from 2.62-2.97, values comparable with those observed in sine-wave experiments when the motoneurone and muscle units were properly matched.

Animals

Normal high energy phosphate ratios in "stunned" human myocardium.

OBJECTIVES: We sought to investigate whether alterations in cardiac high energy phosphates occur in postischemic "stunned" human myocardium. BACKGROUND: Transient postischemic myocardial dysfunction is a common phenomenon that occurs in a variety of clinical settings in the absence of necrosis, and its pathogenesis is still unclear. Cardiac high energy phosphates are reduced during ischemia, and persistently altered myocardial high energy phosphate metabolism has been suggested as a mechanism contributing to stunning. METHODS: We studied 29 patients with a first anterior myocardial infarction (MI) who underwent successful reperfusion within 6 h of the onset of chest pain. These patients underwent 31P magnetic resonance spectroscopy (MRS) a mean of 4 days after MI for measurement of left ventricular contractility and relative high energy phosphate metabolites. Twenty-one patients underwent a second 31P MRS study a mean of 39 days after MI. Eight volunteers served as control subjects. RESULTS: Global and infarct area wall motion scores improved significantly between the early and late studies. No difference was found between early cardiac phosphocreatine (PCr)/beta-adenosine triphosphate (beta-ATP) ratios in patients and control subjects ([mean +/- SD] 1.51 +/- 0.17 vs. 1.61 +/- 0.18, respectively, p = 0.17) or between early and late study results in patients (1.51 +/- 0.17 vs. 1.53 +/- 0.17, respectively, p = 0.6). For alpha of 0.05, the study had a 90% power to detect a 9% difference. CONCLUSIONS: The results of this study demonstrate normal myocardial PCr/ATP ratios in patients with myocardial stunning after reperfusion and suggest that relative cardiac high energy phosphates are not depleted in stunned human myocardium.

Adenosine Triphosphate

[Effects of rejection on the contractile reserve of the graft after heart transplantation].

PURPOSE: To test the hypothesis that rejection could affect the contractility and contractile reserve of left ventricle after heart transplantation. METHODS: Echocardiographic parameters and noninvasive blood pressure end-systolic pressure (ESP), heart rate (HR), end diastolic (EDV) and end-systolic (ESV) volumes, ejection fraction (EF), end-systolic stress (ESS) and the end-systolic relation (ESS/ESV) were recorded in 68 studies in 11 patients, seven days-12 months after heart transplantation. Accordingly with the endomyocardial biopsies results were divided into two groups: group A-with no rejection (53 studies), and group B-with rejection (15 studies). RESULTS: The nitroprusside infusion changed significantly and in the same way, all the parameters except the ESS/ESV ratio (A = 5.5 +/- 1.7 x B = 4.8 +/- 1.5 g/cm2/mL, p = NS); there was a decrease in ESP (A = 107 +/- 15 and B = 109 +/- 12 mmHg, p = NS), EDV (A = 68 +/- 19 and B = 81 +/- 12 mL, p = NS), ESV (A = 12 +/- 5 and B = 18 +/- 12 mL, p = NS) and ESS (A = 59 +/- 13 and B = 82 +/- 20g/cm2, p = NS); there was an increase in HR (A = 94 +/- 9 and B = 93 +/- 16bpm, p = NS) and EF (A = 83 +/- 5 and B = 79 +/- 8%, p = NS). In the dobutamine study it was observed differences for both groups, except for ESP (A = 156 +/- 26 and B = 149 +/- 26mmHg, p = NS). The increase in HR, EF and ESS/ESV ratio was greater in group A (HR-A = 117 +/- 19 and B = 102 +/- 25bpm, p < 0.05; EF-A = 91 +/- 4 and B = 78 +/- 11%, p < 0.05; ESS/ESV-A = 13.1 +/- 6 and B = 6.1 +/- 3.1 g/cm2/mL, p < 0.05). For group A it was smaller the EDV (57 +/- 18 x 94 +/- 35 mL, p < 0.05), ESV (5 +/- 3 x 24 +/- 20 mL, p < 0.05) and ESS (57 +/- 21 x 102 +/- 40 g/cm2, p < 0.05). CONCLUSION: Rejection may not induce changes in resting left ventricular contractility, however, the contractile reserve is depressed during an episode of moderate to severe rejection.

Adult

[Acute effects of ibopamine on left ventricular mechanics and contractility in patients with idiopathic dilated cardiomyopathy].

PURPOSE: The effects of ibopamine (IBO) on left ventricular (LV) mechanics and contractility have not been described. The aim of this study was to test the hypothesis that IBO has a contractile effect at a dose of 200 mg. METHODS: Ten male patients (43 +/- 7 years) with refractory heart failure due to idiopathic dilated cardiomyopathy were studied. The patients were submitted to simultaneous echo-Doppler and hemodynamic (microtip catheter) studies, before (B) and after (20, 40 and 60 minutes) a dose of 200 mg of IBO. LV pressure/diameter and stress/strain relations were obtained. Subsequently, heart rate (HR-bpm), cardiac output (CO-L/m), end-diastolic pressure (EDP-mmHg); fractional shortening (FS-%); maximal elastance (Emax-mmHg/cm/s); end systolic (ESS-g/cm2) and end-diastolic (EDS-g/cm2) stress; chamber (Kp-mmHg/cm) and muscle (K(m)-g/cm2) stiffness, and the time of constant relaxation (Tau-ms) were analyzed. RESULTS: Results were presented as mean +/- standard deviation for conditions before and after IBO (20, 40 and 60 minutes) respectively. There was no change in HR (99 +/- 7; 100 +/- 7; 99 +/- 8; 99 +/- 10). Significant increases were observed in CO (4.13 +/- 1.28; 4.95 +/- 1.38; 5.13 +/- 1.86; 5.18 +/- 1.57), FS (13.7 +/- 2.4; 15.4 +/- 2.8; 15.9 +/- 1.8; 16.1 +/- 2.0), and Emax (14.8 +/- 3.2; 16 +/- 3.6; 17.7 +/- 4.2; 17.6 +/- 4.2). A transient (20 minutes) increase followed by a decrease (40 and 60 minutes) occurred in EDP (26.3 +/- 4.2; 30.6 +/- 6.4; 24.6 +/- 5.6; 22.3 +/- 4.6), EDS (79.7 +/- 22.8; 91.7 +/- 29.6; 79 +/- 31; 63 +/- 17.3), and Kp (27.2 +/- 12.6; 60 +/- 26.7; 27.9 +/- 11.7; 28.1 +/- 11). CONCLUSION: IBO has a beneficial effect on LV systolic and diastolic function as well as on contractility in patients with heart failure due to idiopathic dilated cardiomyopathy.

Adult

[Effects of partial ventriculectomy on left ventricular mechanical properties, shape, and geometry in patients with dilated cardiomyopathy].

PURPOSE: To investigate the short-term effects of the partial ventriculectomy (resection of lateral wall associated to mitral annuloplasty) on cardiac mechanics, contractility, shape and geometry of the left ventricle (LV). METHODS: Eleven male patients with severe congestive heart failure due to dilated cardiomyopathy were studied. The mean age was 51 +/- 7 years and the functional class was III (five patients) or IV (six patients) before the surgery. Patients were evaluated before and at 17 +/- 4 days after the surgery by simultaneous LV pressure and echocardiographic data. End-diastolic pressure (EDP-mmHg), wall stress (EDS-g/cm2) and diameter (EDD-cm); endsystolic wall stress (ESS) and diameter (ESD), fractional shortening (FS-%) and maximal elastance (Emax-mmHg/ cm/s); the diastolic slope of the pressure-diameter (Kp-mmHg/cm) and stress-strain (Km-g/cm2) loops; shape (L/ EDD, adimensional, where L is the LV long axis) and geometry (Th/EDD, adimensional, where TH is the LV diastolic thickness) were obtained. RESULTS: 1) The ressected muscle fragments (diamond shape) were 10.8 +/- 1.3 cm in length and 5 +/- 0.6 cm in width; 2) all patients were discharged from hospital (15-29 days) in class I (eight cases), II (two), and III (one); 3) it was observed a decrease in EDP (24.3 +/- 7.7 x 17.5 +/- 3.2, p = 0.016); in EDD (8.0 +/- 0.7 x 7.2 +/- 0.8, p = 0.002); in EDS (57.9 +/- 26.8 x 37.4 +/- 19.2, p = 0.005); in ESS (199 +/- 46.9 x 102.8 +/- 33.1, p = 0.004); in ESD (7.1 +/- 0.7 x 5.7 +/- 0.8, p < 0.001); in Kp (22.3 +/- 15.9 x 11.5 +/- 6.9, p = 0.014); and in K(m) (467.4 +/- 212 x 214.6 +/- 87.4, p = 0.01); and, 4) it was noted an increase in FS (11.5 +/- 1.8 x 19.8 +/- 3.9, p < 0.001); in Emax (13.8 +/- 2.2 x 18.6 +/- 3.2, p < 0.001); and in L/EDD (1.32 +/- 0.1 x 1.47 +/- 0.13, p < 0.007) and Th/Dd (0.11 +/- 0.04 x 0.17 +/- 0.08, p < 0.038). CONCLUSION: The partial ventriculectomy showed multiple significant beneficial effects in these dilated myopathic hearts.

Adult

[Assessment of the myocardial functional reserve in patients with left ventricular aneurysm by radionuclide ventriculography. Response to isotonic exercise].

PURPOSE: To evaluate global and regional left ventricular (LV) ejection fractions (EF) by radionuclide ventriculography in patients with LV aneurysm at rest and during isotonic exercise. METHODS: Twenty patients were studied by radionuclide ventriculography at rest and during exercise. All patients had been submitted to cineangiography and showed LV aneurysm post myocardial infarction. RESULTS: Patients were divided according to LV EF in two groups: one with EF > or = 40% and the other with < 40% EF. Both groups showed normal response of global EF to exercise: mean rest EF was 40 +/- 14% and mean exercise EF was 45 +/- 14% (p < 0.01). When groups were considered separately, EF values showed the same behavior. Half of the patients showed normal response to exercise and the other half showed abnormal response. These changes were not associated with resting EF values, but were due to regional EF of lateral wall, that changed from 44 +/- 7 to 48 +/- 7% in the group of patients with normal LV EF response to stress and from 50 +/- 5 to 46 +/- 5% in those with abnormal response (p < 0.01). CONCLUSION: The evaluation of regional ventricular EF by radionuclide ventriculography during exercise better discriminates functional reserve in patients with LV aneurysm than resting global EF. These findings could help the decision making of the therapeutic approach in this specific group of patients.

Aged

[The repair of inguinal and/or crural hernias with giant Mersilene prostheses in the preperitoneal position].

The authors present 44 patients operated for hernias (inguinal and/or femoral) with a median pre-peritoneal approach positioning a mersilene mesh with Stoppa's technique. The results are very interesting considering that the hernias treated are all at high risk of recurrence. We had 4 complications (1 bleeding and 3 wound infections) that were conservatively treated, no mortality at all. The follow-up was of 12 months (mean) and no recurrence was discovered.

Aged

[Magnetic resonance imaging in study of the temporo-mandibular joint. II. Pathologic findings].

A total of 107 temporomandibular joints (TMJ) were examined with two superconductive MR units at 1T and 1.5T. In 73 TMJs, MR revealed 55 disk displacements, 7 disk perforations, 10 joint space adhesions, 33 osteoarthrities, 3 avascular necroses of the mandibular condyle, and 25 joint effusions. These abnormalities are described and discussed. In spite of some limitations--e.g., motion artifacts and patients' claustrophobia--MR imaging is the procedure of choice in abnormal TMJs, because it yields useful information as to therapeutic choice (conservative versus surgical). Arthrography can be used as a complementary study technique in the patients with marked disagreement between clinical and MR findings. Arthroscopy should be used as a surgical procedure in abnormal TMJs selected by previous MR studies.

Adolescent

[Delayed consolidation and pseudarthrosis in posttraumatic pathology of the carpal scaphoid. A magnetic resonance study].

Delayed unions and fibrous or sclerotic non-unions of the carpal scaphoid are frequent sequelae of non-diagnosed or not properly treated fractures. The most important cause of abnormal unions is ischemic necrosis, due to the terminal vascularity of the carpal scaphoid. Conventional X-rays, scintigraphy, and CT do not yield sufficient information for a complete diagnosis; at present, MR imaging represents a valuable alternative, for it is a noninvasive technique able to provide a "biological imaging" of bone. Fourteen patients underwent surgical/nonsurgical treatment, based on the findings supplied by MR imaging. MR reliability was evaluated in relation to the therapeutic results obtained. The study proved MR imaging to provide important information as to therapy planning; in case of surgical treatment, MR imaging helped in choosing the most appropriate location for the insertion of bone graft or screw.

Adolescent

Management of cervical cancer and surgical-pathological staging (SPS). Report of our clinical case series.

FIGO staging is imprecise in a relevant number of cases of cervical cancer, especially in advanced stages, when the prognosis and the choice of the therapy are most delicate. The Authors examine their case series about the index of correction of FIGO staging after Surgical Pathological Staging (SPS). Surgical Pathological Staging was applied systematically in 788 cases and revealed errors in FIGO staging in 16% of cases at stage I; 77% at stage II; and 96% at stage III. SPS allows a more precise knowledge of neoplastic diffusion and consequently to the elimination of many false advanced stages and to adequate the treatment. Furthermore 5 year survival rate confirms the role of SPS and Surgical therapy alone or combined with Radiotherapy and Chemotherapy in every stages of diffusion of cervical cancer.

Female

Clinical considerations on the metastases of mammarian cancer.

The Authors examine the prognostic value of metastatic breast cancer and the consequent possibility of therapy. They discuss the role of steroid receptor determination both in prognosis and in planning treatment. Their personal experience confirms the positivity of Progestinic receptors as a more specific index of hormono-sensitivity in regard to the positivity of the single estrogen receptors. Concerning therapy, in metastatic breast cancer the association between chemo- and hormono-therapy may offer better results, acting on different cell populations, though it probably does not improve the survival rate.

Breast Neoplasms

Absorbed power distributions from single or multiple waveguide applicators during microwave hyperthermia.

A theoretical model has been developed to calculate the power distributions in biological-like tissues in direct contact with waveguide applicators. A numerical solution of the coupled integral equations is performed by means of their transformation into matrix equations by using the method of moments, where the biological tissue and the applicator are described by two independent matrices. The model permits an accurate evaluation of the electric field at the aperture. The application of this method for the evaluation of arrays is also discussed. Power contour plots produced by applicators routinely used in clinics have been computed and compared with experimental results obtained with tissue-equivalent phantoms for three typical bodies: homogeneous, stratified and inhomogeneous.

Humans

Computer modelling of brain cortex excitation by magnetic field pulses.

In spite of many clinical and experimental applications, the technique of transcranial magnetic stimulation still presents obscure aspects. This especially concerns safety parameters and the exact characterization of the current induced by a single magnetic pulse. The model proposed consists of an equivalent electric network derived by Maxwell's equations and applied to discretized magnetic resonance imaging of a normal subject. This model allows accurate prediction of current distribution, charge per phase and dissipated energy.

Cerebral Cortex

An accurate 3-D model for magnetic stimulation of the brain cortex.

We present a 3-D model for the simulation of a realistic clinical situation during magnetic stimulation. The electromagnetic problem is solved by reconstructing the inhomogeneous head tissues from magnetic resonance images and associating relative values of conductivity to each tissue. Application of Maxwell's equations in the integral form leads to an equivalent 3-D electrical network, whose solution gives the current density distribution in the brain. The high spatial resolution and rigorous electromagnetic approach make this model an accurate and useful tool for stimulator design and for estimating the efficiency and safety of this clinical methodology.

Algorithms