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Biomedical subjects

G Mari

Publications and source records attributed to G Mari.

At least 55 records · Page 3Linked to original sources
PubMed1995

Abdominal venous system in the normal fetus.

OBJECTIVE: To assess flow velocity waveforms of the abdominal venous system in the normal fetus. METHODS: Sixty-seven normal fetuses between 17-42 weeks' gestation were each studied once. Flow velocity waveforms were obtained from the following: 1) umbilical vein at the entrance into the abdomen, 2) umbilical sinus, 3) portal vein before its division, 4) anterior division of the portal vein, 5) posterior division of the portal vein, 6) ductus venosus at its origin from the umbilical vein, 7) splenic vein at its origin, 8) splenic vein close to the umbilical sinus, 9) renal vein, 10) adrenal vein, 11) common iliac vein before the origin of the inferior vena cava, 12) inferior vena cava, and 13) left hepatic vein. RESULTS: Five different patterns were noted on the velocity waveforms of the abdominal venous system: continuous, monophasic, biphasic, triphasic, and tetraphasic. CONCLUSION: In the normal fetus, all veins leading to the liver have continuous flow, except the umbilical sinus, which has a monophasic pattern. The ductus venosus has a biphasic pattern. The veins that open into the inferior vena cava have triphasic flow velocity waveforms. The left hepatic vein occasionally has a tetraphasic pattern.

Abdomen↗
PubMed1995

Total thyroidectomy in the treatment of thyroid cancer.

Considerable controversy exists about the most appropriate treatment for thyroid cancer. In this report the authors present their experience of 189 patients, all of whom had a total thyroidectomy between June 1980 and December 1993. The age of the patients ranged from 11 to 78 years (mean age: 42 years), there were 144 women and 45 men. Histological types were: 146 papillary, 16 medullary, 10 follicular, eight Hurtle, six insular and three undifferentiated. Coexistent lesions included: 22 thyroiditis, 17 adenomas, one Graves' disease and 22 benign goitre. Fifty-six (29.6%) patients had multifocal papillary cancer (bilateral in 45 cases). Surgical complications included 20 cases of transient recurrent laryngeal nerve palsy, 16 cases of transient and one of permanent hypoparathyroidism, and one respiratory obstruction due to bilateral recurrent laryngeal nerve palsy that required temporary tracheostomy. Two patients were reoperated on due to bleeding. Ninety per cent of patients were discharged within 3 days of thyroidectomy. One hundred and fifty patients were evaluated for 131I treatment by a standardized dosimetry procedure 4 weeks after surgery. Dosimetry was also used to calculate therapeutic 131I doses. Seventy-six patients did not show a 131I uptake above background levels, 56 underwent therapeutic 131I, while in the 18 patients who showed an abnormal uptake of 131I it was decided not to give the therapeutic dose. The authors conclude that total thyroidectomy can be performed with a minimum of permanent disability in patients with malignant thyroid tumours. The theoretical and practical advantages of this kind of surgical strategy make it the treatment of choice for thyroid cancer.

Adolescent↗
PubMed1995

Diagnosis of fetal anemia with Doppler ultrasound in the pregnancy complicated by maternal blood group immunization.

We investigated whether Doppler measurement of the fetal middle cerebral artery peak systolic velocity can be used to detect fetal anemia in pregnancies complicated by maternal blood group immunization. We first studied normal values for the middle cerebral artery peak systolic velocity in 135 fetuses (Group A), and also in 23 fetuses at risk for anemia who underwent 56 cordocenteses to assess the fetal hematocrit (Group B). A test to detect fetal anemia, based on the middle cerebral artery peak systolic velocity, was developed by using the data of the fetuses of Group A and Group B. Successively, the middle cerebral artery peak systolic velocity was prospectively determined in 16 fetuses at risk for anemia who underwent 42 cordocenteses (Group C) to assess the test developed, in a multicenter prospective fashion, by using the data of Group A and Group B. In the normal fetuses an exponential model expressed the increase of the middle cerebral artery peak systolic velocity values with advancing gestation. By using the data of the fetuses of Group A and Group B, four zones of anemia risk were identified. In Group C, none of the anemic fetuses had the middle cerebral artery peak velocity below the normal mean value, whereas all of the anemic fetuses had the peak velocity above the normal mean. The middle cerebral artery blood velocity increases with advancing gestation and is a non-invasive method of detecting anemia in pregnancies complicated by maternal blood group immunization.

Adult↗
PubMed1995

Blood flow velocity waveforms of the abdominal arteries in appropriate- and small-for-gestational-age fetuses.

The aim of this study was to describe flow velocity waveforms of abdominal arteries in the appropriate- and small-for-gestational-age fetus. Splenic artery, superior mesenteric artery, hepatic artery and renal artery velocity waveforms were obtained from 57 appropriate-for-gestational-age and nine small-for-gestational-age fetuses with color flow Doppler ultrasonography. The pulsatility index was used to quantify the arterial waveforms. Repeated measure analysis of variance indicated significant differences in the pulsatility index values in both the appropriate-for-gestational-age and small-for-gestational-age fetuses. A multiple comparison test revealed a significantly lower value for the pulsatility index in the splenic artery when compared to that of the other vessels for both the appropriate- and small-for-gestational-age fetuses. In the small-for-gestational-age fetuses, a lower pulsatility index value was observed at the superior mesenteric artery level when compared to the renal artery. Because of its lower frequency of successful insonation, the hepatic artery was not considered for the analysis. In the normal fetus, the splenic artery had the lowest pulsatility index when compared to the other arteries we investigated. This difference remained in small-for-gestational-age fetuses, reflecting a lower vascular resistance at the fetal spleen in both normal and small-for-gestational-age fetuses. It appears that in small-for-gestational-age fetuses the renal artery has a higher pulsatility index than the superior mesenteric artery, suggesting a preferential distribution of blood flow to the bowel.

Abdomen↗
PubMed1994

Ultrasonographic fetal iliac length measurement in the screening for Down syndrome.

OBJECTIVE: Pelvic bone abnormalities are common in newborns with Down syndrome. The aim of this study was to evaluate the utility of ultrasonographic iliac bone length measurement in the identification of fetuses with Down syndrome in the second trimester of gestation. STUDY DESIGN: Ultrasonographic iliac length measurement was obtained, in an axial view of the fetal pelvis, on 10 fetuses with Down syndrome and 180 karyotypically normal fetuses before genetic amniocentesis. Regression equations relating biparietal diameter to iliac length measurement were used to calculate ratios of observed-to-expected length, sensitivity, and specificity at various cutoff points. RESULTS: Linear regression of iliac length measurement on biparietal diameter for normal fetuses resulted in the following equation: iliac length measurement (centimeters) = -0.2723 + 0.0333 biparietal diameter (millimeters). Iliac length measurement in Down syndrome fetuses was significantly longer than in normal controls (p < 0.0001). A ratio of 1.21 for observed-to-expected iliac length measurement yielded a sensitivity of 40%, a specificity of 98%, and positive predictive values of 50% and 2.60%, respectively, in populations at risk for Down syndrome of 1 in 20 and 1 in 750. CONCLUSION: Iliac length measurement is increased in fetuses with Down syndrome. An observed-to-expected iliac length measurement of > or = 1.21 has a positive predictive value of 1/38 in a low-risk population with a false-positive rate of 2%. This preliminary study suggests that iliac length measurement may be useful as an ancillary screening variable in antenatal screening for Down syndrome.

Adult↗
PubMed1994

Regional cerebral flow velocity waveforms in the human fetus.

The purpose of this study was to determine regional cerebral flow velocity waveforms in the human fetus. Flow velocity waveforms were determined at the level of the middle cerebral artery, vertebral artery, and intracerebellar arteries in 25 fetuses between 23 and 39 weeks' gestation. The pulsatility index was used to quantify the waveforms. Technically acceptable waveforms were obtained at all three vessels in 20 fetuses. The pulsatility index was lowest for the intracerebellar artery in all the fetuses studied. The pulsatility indices of the vertebral artery and middle cerebral artery were not significantly different. These data suggest that significant fetal regional cerebral blood flow differences occur in utero, with intracerebellar arterial resistance being lower than resistance in other regions of the brain.

Adult↗
PubMed1993

Numerical and functional modifications in platelets induced by polyester coated by a hydrophilic polymer.

We evaluated the alterations in number, functionality and release reaction of the platelets contained in plasma, filtered through a polyester filter and coated with a hydrophilic polymer. The alterations in number were examined by counting before and after filtration. The morphological modifications were studied by determining the mean platelet volume. The functional alterations were analysed by a platelet aggregation test, induced by ADP and collagen. The presence of products from the release reaction in filtered plasma was studied using radioimmunoassays of beta-thromboglobulin, platelet factor 4 and thromboxane B2. The results obtained showed that the filtration of plasma through the material did not determine a significant platelet adhesion, did not alter the volume or the functionality of the platelets and induced no release reaction.

Biocompatible Materials↗
PubMed1993

[Assessment of the plasma phase of coagulation in platelet-rich plasma after passage through a special polyester filter].

The authors have examined the alterations in the coagulation pathway of plasma filtered through a polyester filter coated by a hydrophilic polymer. The activation of the coagulation pathway was evaluated by measuring prothrombin time, activated partial thromboplastin time, coagulation factors and fibrinopeptide A. The results obtained demonstrate that the examined filter does not induce significative activation of the coagulation pathway.

Blood Coagulation↗
PubMed1993

Fetal renal artery flow velocity waveforms in normal pregnancies and pregnancies complicated by polyhydramnios and oligohydramnios.

OBJECTIVES: To determine 1) flow velocity waveform patterns in the fetal renal artery in normal pregnancies and pregnancies complicated by polyhydramnios or oligohydramnios, and 2) fetal urine output in twin gestations complicated by polyhydramnios-oligohydramnios syndrome. METHODS: Doppler waveforms were recorded in 121 normal fetuses, ten fetuses with oligohydramnios, ten with polyhydramnios, and eight sets of diamnionic twins with polyhydramnios in one gestational sac and oligohydramnios in the second sac. In the twins, the fetal urine output was also estimated. RESULTS: The pulsatility index (PI) of the renal artery in normal fetuses decreased linearly with advancing gestation. Abnormal renal artery PIs were found in four fetuses with oligohydramnios. The values in the singleton pregnancies complicated by polyhydramnios were in the range of normality for our reference limits for gestation. The PI of the renal artery in the twins with polyhydramnios was significantly lower than that from the twins with oligohydramnios. The urine output was significantly higher in twins with polyhydramnios than in twins with oligohydramnios. CONCLUSIONS: Normal pregnancies are associated with changes in the renal artery flow velocity waveforms. In fetuses with oligohydramnios, the worst fetal outcome seems to be associated with abnormal renal artery flow velocity waveforms. In fetuses with polyhydramnios, no abnormal renal artery flow velocity waveforms were found. Changes in renal perfusion influence urine output in twin gestations complicated by polyhydramnios-oligohydramnios.

Blood Flow Velocity↗
PubMed1992

Middle cerebral artery flow velocity waveforms in normal and small-for-gestational-age fetuses.

The middle cerebral artery flow velocity waveforms were obtained in 16 normal fetuses in a longitudinal study and in 128 normal fetuses in a cross-sectional study with pulsed Doppler ultrasonography. The pulsatility index values of the middle cerebral artery were higher at 25 to 30 weeks' gestation than those observed during the two periods of major cerebral cellular multiplication in the human fetus. In 9 of the 16 fetuses studied longitudinally we compared the pulsatility index values obtained at the end of gestation with those obtained at 1 month after delivery; no significant difference was observed. The pulsatility index of the middle cerebral artery was also determined in 33 small-for-gestational-age fetuses. A middle cerebral artery pulsatility index value below our normal range was recorded in 9 of the 33 small-for-gestational-age fetuses (27.3%). These small-for-gestational-age fetuses with abnormal pulsatility index values had a significantly higher incidence of abnormal fetal heart rate and admission into the neonatal intensive care unit. There were three deaths in the nine small-for-gestational-age fetuses with abnormal pulsatility index values (33.3%) and three deaths in the 24 small-for-gestational-age fetuses with normal pulsatility index values (12.5%). Our data indicate that the pulsatility index of the middle cerebral artery in the normal human fetus has a parabolic pattern during pregnancy and does not change significantly after delivery. The results suggest that the small-for-gestational-age fetus with a normal middle cerebral artery pulsatility index is at lower risk than the fetus with abnormal pulsatility index values; moreover, management of the small-for-gestational-age fetus may be aided by the study of the middle cerebral artery waveforms.

Blood Flow Velocity↗
PubMed1991

[Lymph node localization of gastrinoma. Diagnosis and treatment].

The case of a 48-year old woman with a lymph node localization of gastrinoma is reported. The preoperative workup (US-scan, TC-scan and NMR) made it possible to detect and localize the lesion. A conservative surgical approach was decided according to the latest literature reports which showed a favourable course in patients with lymph node gastrinoma. Surgical resection has been accomplished. The patient's hormone level was normal at one-year follow-up.

Female↗
PubMed1991

Doppler assessment of renal blood flow velocity waveforms in the anemic fetus before and after intravascular transfusion for severe red cell alloimmunization.

Image-directed pulsed Doppler ultrasonography demonstrated a decrease in the pulsatility index of the renal artery in 9 anemic fetuses (less than 30 weeks, menstrual age) soon after intravascular transfusion. The pulsatility index returned to pretransfusion values the day following the transfusion. End diastolic blood velocity in the renal artery could not be measured before the transfusion, was detectable immediately after the procedure, and was again nonmeasurable one day after the transfusion. These data suggest an increase in renal blood flow in the anemic fetus soon after intravascular transfusion to eliminate excess fluid.

Anemia↗
PubMed1991

Arterial blood flow velocity waveforms of the pelvis and lower extremities in normal and growth-retarded fetuses.

Serial measurements of femoral artery flow velocity waveforms were made at specified intervals of 3 to 4 weeks from 15 to 20 weeks of gestational age to 35 weeks and 1- to 3-week intervals thereafter until delivery in 12 normal fetuses (group 1A) with pulsed Doppler ultrasonography. The pulsatility index of the femoral artery increased linearly with advancing gestation in all 12 fetuses; this was associated with reverse diastolic flow velocity waveforms. In 30 other normal fetuses (group 1B) whose gestational ages ranged between 16 and 38 weeks (mean +/- SD, 29.5 +/- 5.6 weeks), the femoral artery flow velocity waveforms were analyzed with the external iliac artery, internal iliac artery, and umbilical artery waveforms. No significant difference was observed between the pulsatility index of the external iliac artery and that of the femoral artery (mean +/- SD, 3.7 +/- 1.1 vs 3.7 +/- 1.1). The pulsatility index of the internal iliac artery was significantly higher than that observed in the umbilical artery (mean +/- SD, 1.27 +/- 0.28 vs 1.12 +/- 0.23). The femoral and umbilical artery velocity waveforms also were determined in 20 fetuses with intrauterine growth retardation (group 2), whose gestational ages ranged between 24 and 36 weeks (mean +/- SD, 31 +/- 3.4 weeks). Abnormal femoral artery pulsatility index was recorded in two fetuses who died. Absent or reverse flow of the umbilical artery was recorded in 10 fetuses; four of them died, and four others manifested fetal distress or required admission to the neonatal intensive care unit or both. These preliminary data suggest that the femoral artery pulsatility index cannot be used as an indicator of adverse fetal outcome, whereas absent or reverse flow of the umbilical artery seems to be better correlated with adverse fetal outcome.

Analysis of Variance↗
PubMed1991

Flow velocity waveforms of the fetal circulation preceding fetal death in a case of lupus anticoagulant.

Flow velocity waveforms of the vascular system were evaluated at 25 weeks 2 days and 27 weeks 5 days of gestation in the case of a severely growth-retarded fetus. At the first scan, the cerebral vessels displayed low pulsatility indexes, reflecting the brain-sparing pattern that characterizes fetal stress. This compensatory reduction was lost at the time of the second, "preterminal" scan.

Adult↗
PubMed1991

Amniotic fluid glucose and intraamniotic infection.

Thirty-nine patients with either premature labor and/or preterm premature ruptured membranes underwent transabdominal amniocentesis to enable the following amniotic fluid analyses to be performed: culture and sensitivity, Gram's stain, and glucose determination. All nine patients with intraamniotic infection had amniotic fluid glucose values less than 10 mg/dl. Three patients with amniotic fluid glucose levels less than 10 mg/dl but without chorioamnionitis were delivered of infants within 72 hours of admission. The mean amniotic fluid glucose level of patients with intraamniotic infection (5 +/- 2.4 mg/dl) was significantly lower than in those without intraamniotic infection (39.8 +/- 18.42 mg/dl). All patients with amniotic fluid glucose values less than 10 mg/dl had either bacteria and/or white blood cells on Gram's stain. Two patients without chorioamnionitis had white cells on Gram's stain and amniotic fluid glucose values greater than 10 mg/dl. It appears that amniotic fluid glucose is more sensitive and more specific than Gram's stain in the diagnosis of intraamniotic infection. All 12 patients with low amniotic fluid glucose values were delivered of infants within 72 hours as the result of either the presence of infection or the progression of labor.

Amniotic Fluid↗
PubMed1991

Long-term indomethacin therapy decreases fetal urine output and results in oligohydramnios.

Four quadrant quantitative amniotic fluid volume (length, width, and depth) was performed in six fetuses prior to and during indomethacin therapy for preterm labor in patients with normal amniotic fluid volume prior to therapy. The dose of indomethacin was 25 mg orally every 6 hours. One patient had to have the dose reduced to 25 mg every 12 hours due to constriction of the ductus arteriosus. Fetal urine output was determined prior to and during indomethacin therapy. The mean pretherapy amniotic fluid volume of 341.5 +/- 43.2 mm declined to 97 +/- 9.3 mm at the time of discontinuation of indomethacin for oligohydramnios. This occurred after 15 days of 25 mg indomethacin orally every 6 hours in four patients and after 28 days at 25 mg indomethacin every 12 hours in the remaining patient. Fetal urine output prior to and following indomethacin was 4.93 +/- 14 ml and 1.73 +/- 0.6 ml/hr, respectively. Prolonged indomethacin therapy results in decreased fetal urine output with resultant oligohydramnios and appears to be the major limiting factor aside from ductal constriction to long-term indomethacin therapy.

Adult↗