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Biomedical subjects

G Masini

Publications and source records attributed to G Masini.

At least 19 recordsLinked to original sources
PubMed1995

[Total atrioventricular block as the primary clinical manifestation of undiagnosed aortic dissection].

We describe the case of a 54-year-old male who was examined due to light chest pain experienced the previous day. The man was admitted to the cardiology division for the presence of a complete atrioventricular block. On admission the echocardiogram showed a large aortic regurgitation not present two years earlier. Suspecting an aortic dissection we performed a transesophageal echocardiography and a contrast computerized tomography: the two examinations were negative. The next days the patient had two episodes of acute pulmonary edema so he was transferred to the regional reference hospital where an hemodynamic unit and cardiac surgery division were available. There, he repeated a transesophageal echocardiography which was negative. The man had aortic valve replacement without angiography for his very critical condition. The surgeon identified a small aortic dissection, just above the aortic valve plane, which was responsible for valve leaflets prolapse and aortic regurgitation; the hematoma deepened towards the interatrial septum and atrioventricular junction justifying the atrioventricular block. In conclusion, a small aortic dissection can offer an atypical picture, and in this condition even very valuable diagnostic techniques may fail the diagnosis.

Aortic Dissection↗
PubMed1991

[Atrial tachyarrhythmias in sinus node disease: diagnostic and therapeutic problems].

It is known that sinus node dysfunctions can, in some instances, be accompanied by paroxysmal supraventricular arrhythmias. It is however not completely understood if, in these patients, it is present a situation of electrical atrial vulnerability or an electrophysiological condition which may represent the substrate for these arrhythmias. With the aim to solve this issue, 23 patients with sinus node dysfunction (8 of whom with atrial tachyarrhythmias) underwent a complete electrophysiological study, according to the protocol of the Italian Group of Cardiac Electrophysiology. The results of the electrophysiologic study allowed to demonstrate that in 75% of patients with atrial tachyarrhythmias it was possible to reproduce the arrhythmia by means of a low aggressive protocol. Also, in these patients, an inter- and intra-atrial conduction disturbance was demonstrated and, with respect to those patients without arrhythmias, the atrial refractory period was shorter in basal conditions and during induced atrial rhythm with cycle length of 600 ms, it was longer in left atrium than in high right atrium, and it shortened to a lesser extent with the shortening of the cardiac cycle.

Anti-Arrhythmia Agents↗
PubMed1990

[Comparison of lidoflazine and quinidine in the conversion to sinusal rhythm in atrial fibrillation of recent onset].

In order to compare the efficacy of oral lidoflazine (240 mg/die) and oral quinidine (1200 mg/die) in re-establishing sinus rhythm, we studied 115 patients (mean age 63.8 years; range 32-91) with atrial fibrillation of recent onset (less than 3 months). Patients with cardiac failure, acute myocardial infarction, severe intraventricular conduction disturbances, kaliemia less than 3.8 mEq/L or digoxinemia greater than 2 ng/ml were not included. Patients were randomly given one of the 2 drugs, until conversion to sinus rhythm was achieved, severe side effects occurred or for a maximum therapy of 5 days. No significant differences were present between the 2 groups in terms of age, male/female ratio, duration of atrial fibrillation, presence of an enlarged left atrium, presence of organic heart disease (or arterial hypertension) or digitalis therapy. Sinus rhythm resumption was obtained in 41/58 (71%) patients treated with quinidine and in 47/57 (82%) patients treated with lidoflazine (p = ns). In successful cases, the mean treatment time was 79 +/- 33 (SD) hours for quinidine and 66 +/- 36 hours for lidoflazine (p = ns). Both drugs showed the same efficacy in 3 subgroups of patients in whom the arrhythmia had different duration (less than 24 hours; between 24 hours and 3 days; more than 3 days). Treatment was stopped in 5 patients receiving quinidine (gastrointestinal side effects) and in 3 patients receiving lidoflazine (frequent premature ventricular beats in 2 and polymorphic ventricular tachycardia of the "torsade de pointes" type in 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Efficacy of mexiletine in chronic ventricular arrhythmias: a multicentre double-blind medium-term trial.

In a multicentre double-blind, inpatient, placebo-controlled trial the effects on premature ventricular beats (PVBs) of mexiletine in a standard, submaximal dose were studied by Holter monitoring in 144 outpatients. After wash-out, mexiletine was administered for 14 days. The effects were re-tested, after one week of a placebo, in a second 14-day period of mexiletine administration. Of the patients 73% in the first period and 82.5% in the second period responded to mexiletine (a reduction of 75% or more of PVBs/24 h--p less than 0.001 compared with the placebo for both periods). Mexiletine also significantly reduced the Lown class of PVBs and the frequence of paired PBVs, ventricular tachycardia, multiform beats and R on T wave phenomenon. Mexiletine showed an equivalent effectiveness in the four main aetiological groups of arrhythmias. Fifty nine patients complained of adverse effects (gastrointestinal or neurological) the intensity of which led to the stopping of the treatment in 16 of them. These results show that mexiletine is highly effective, even in submaximal doses, in preventing ventricular arrhythmias of whatever origin.

Adult↗
PubMed1986

Sinus node pacemaker shift: a phenomenon induced by premature atrial stimulation in man?

The aim of this study was to investigate whether premature atrial stimulation is able to induce a shifting of the sinus node pacemaker. For this purpose we compared, in 18 patients, the curve of sinus node function obtained with Strauss' method with that resulting from the scanning, with premature atrial stimulation, of the first returning cycle following a single premature induced atrial beat. We found that the length of the compensatory phase (zone I) evaluated on the curve resulting from the scanning of the first returning cycle following the single premature induced atrial beat was shorter (15%) than that observed with the original Strauss method. In addition, an inverse relationship between the shortening of the compensatory zone and the estimated sinoatrial conduction time was observed. This result could be accounted for by one of the following explanations: 1) a change in the sinoatrial conduction or in the sinus pacemaker automaticity; 2) sinus node reentry; 3) sinus node pacemaker shift. Even if there is no direct evidence either to prove or to exclude one or more of these explanations, sinus node pacemaker shift seems to be the most convincing explanation.

Adult↗
PubMed1985

Pyelovesicostomy: an alternative to ureteropelvic junction-plasty in pelvic ectopic kidneys.

Pyelovesicostomy was performed in 2 cases of hydronephrosis in pelvic kidneys secondary to ureteropelvic junction obstruction. In the first patient, who presented with a solitary kidney, the procedure was done after failure of a dismembered pyeloplasty, while in the second patient the procedure was performed electively. Both patients had sterile urines and stable renal function, although some dilatation persisted in the first case. The indications and the functional aspects of this surgical solution are discussed.

Adult↗
PubMed1985

Vaginal calculi associated with vesicovaginal fistulae.

Three cases of endovaginal stones associated with vesicovaginal fistulae are described. One fistula was of congenital origin, and the other two were recurrent post-hysterectomy fistulae. Other possible causes of this unusual stone location are neurogenic bladder, ectopic ureteral orifice and vaginal outlet obstruction. The radiologic appearance and the surgical treatment of vaginal calculi are discussed.

Aged↗
PubMed1984

Treatment of male urethral calculi.

We treated 14 male patients for urethral stones during a 17-year interval. The calculi were located in the posterior urethra in 7 patients and in the anterior urethra in 7. Anatomical alteration of the lower urinary tract was an important predisposing factor, since 11 patients had history of bladder and urethral surgery or disease, 2 had an associated neurogenic bladder, 6 had urethral strictures or diverticula and 3 had concomitant bladder stones. Urethroplasty was performed in 5 cases, surgical removal of the stone in 3, retrograde manipulation inside the bladder in 4 and electrohydraulic endourethral lithotripsy in 2. The latter technique appears to be particularly effective for endoscopically accessible stones.

Adolescent↗
PubMed1984

[Electrophysiologic characterization of propafenone in man].

We performed an electrophysiologic study in 10 subjects before and after administration of Propafenon in doses of 1,5 mg/Kg b.w. i.v. in 2-3 minutes. No symptoms and no significant reductions of arterial blood pressure were observed. The analysis of our data shows that Propafenon does not significantly influence the sinus node function and the sinoatrial conduction. As far the atrioventricular conduction, the drug caused a significant increase of the Wenckebach point, of St-Q interval duration and of the A-V node absolute refractory period. The H-V interval and the His-Purkinje refractory period were also increased. We conclude that P exerts a negative dromotropic effect by direct pharmacological action on the A-V node and on the intraventricular specific conduction pathways.

Anti-Arrhythmia Agents↗
PubMed1983

[Hyperkinetic ventricular arrhythmia induced by atropine administration].

We report the case of a patient with ventricular tachyarrhythmia, which occurred after atropine was given intravenously for diagnostic purposes. The arrhythmia was accompanied with precordial pain and nitroglycerin promptly reduced both events. On the ECG an elevated ST segment in leads I, aVL, V4, V5, V6 was observed for few hours after the end of the arrhythmia, followed by a pattern of myocardial ischemia. Serum enzymes were repeatedly normal. Spontaneous anginal attacks, usually accompanied with ECG signs of myocardial ischemia and 2nd degree AV block, were often observed by means of 24 hours ECG monitoring (Holter) in the following weeks, in spite of appropriate treatment. Either myocardial ischemia, induced by the increased heart rate following atropine administration, or direct electrophysiologic effects of the drug upon the ventricle muscle (possibly in association with ischemia) could have caused the ventricular arrhythmia.

Atropine↗
PubMed1982

Experience with ureterocalyceal anastomosis.

Experience with 10 cases of ureterocalyceal anastomosis is reported. Most cases involved scleroatrophic scarring of the pelvis after repeated stone surgery, and 1 case each for failed pyeloplasty, tuberculous stricture of the pelvis, transitional cell carcinoma of the pelvis and calyces, and ureteropelvic junction obstruction associated with renal malformation. Three patients had a solitary kidney. End-to-end ureterocalyceal anastomosis was performed in 5 patients; laterolateral in 1 case, and ureteropyelocalyceal anastomosis in the remaining 4. In 3 cases omentoplasty was also performed.

Adult↗
PubMed1981

Conservative surgery for renal cell carcinoma.

The authors present their clinical experience in conservative surgery for renal cell carcinoma, which was performed in two cases of simultaneous bilateral tumours, in a case of neoplasm in solitary kidney, in two cases of cancers with damaged contralateral kidney and in two cases of association between cyst and small tumour. All patients are alive and without evidence of residual or recurrent malignancy with a followup ranging between 6 months and 7 years. The pros and cons of the various surgical solutions are discussed.

Adenocarcinoma↗
PubMed1981

[Atrial stimulation and intranodal migration of sinus pacemaker in man (author's transl)].

In order to demonstrate, in man, sinus node pacemaker shift following atrial stimulation, we compared, in 26 patients, the curve of sinus node function obtained with Strauss' method with that resulting by the scanning with premature atrial stimulation of the first returning cycle following either a single premature atrial induced beat (140 ms shorter than the basic cycle) (group A), or a train of 8 consecutive atrial beats induced with a rate slightly faster (10 beats/m) than the control sinus rhythm (group B). Assuming that no changes in sinus pacemaker automaticity or in sinoatrial conduction occur owing to atrial stimulation, curves with the same shape should be observed if the site of the dominant pacemaker remains unchanged: whereas, different lengths of the compensatory phase (zone I) should be expected if an intranodal pacemaker shift occurs. For evaluating the length of the compensatory zone (zone I), we calculate, on the curve of the sinus node function, the mean value of the relation points included in the first third of the reset zone (zone II). According to our results, the length of the compensatory phase (zone I) evaluated on the curve resulting by the scanning of the first returning cycle following either a single premature atrial induced beat (group A), or eight consecutive atrial beats (group B) was shorter than that observed with the original Strauss' method (10% and 18% respectively). However, only in the group B, this difference was statistically significant. In addition, a significant inverse relationship between the shortening of the compensatory zone and the sinoatrial conduction index was also observed. Considering that our results have been corrected in such way as to repeal eventual changes in sinus pacemaker automaticity or sinoatrial conduction following atrial stimulation, the shortening of the compensatory zone, we have observed in our patients, strongly suggests an intranodal sinus pacemaker shift. If we assume that this result could represent an indirect evidence of this phenomenon, some clinical implications may follow: 1) another limitation, in addition to others known (intraatrial conduction delay, sinus arrhythmia, changes in sinus node automaticity, difference between retrograde and antegrade conduction time) could decrease the accuracy of atrial stimulation techniques in the estimation of the sinoatrial conduction time; 2) sinus pacemaker shift following atrial stimulation, may induce an understimulation of the true sinoatrial conduction time; however, according to our results, the error is generally small, so that it does no preclude the usefulness of atrial stimulation techniques in the evaluation of sinoatrial conduction; 3) the more evident and significant shortenings of the compensatory phase occurred with atrial pacing technique: this finding could explain why shorter sinoatrial conduction times are generally observed with Narula's method in comparison with Strauss' method.

Adult↗
PubMed1980

[Radiological evolution of renal pelvis tumours (author's transl)].

The tumours of renal pelvis show a polymorphic radiological pattern, often rather difficult to interpret, sometimes even not evident owing to the presence of some other pathology. The most characteristic cases, and to be considered specimen, found in researches executed at different times, are represented by carcinomas, among which the ones showing the most elevated histological malignancy present a more rapid and infiltrative growth, as testified by repeated radiological tests.

Adult↗
PubMed1979

[Diagnostic value of the continuous electrocardiographic monitoring (Holter) and of the electrophysiologic testings in patients with sino-atrial node dysfunction (author's transl)].

A twenty-four hours electrocardiographic recording and an electrophysiological study were performed in 48 patients with sinus bradycardia, 21 of them with symptoms suggesting a sino-atrial dysfunction. Both methods, and independently one each other, were not diagnostic in all symptomatic patients; on the contrary, they showed sinus dysfunction in patients without symptoms related to sino-atrial node dysfunction. These results induce to conclude that the two methods are complementary and that their results must be ever critically accepted, especially when a permanent cardiac pacing is indicated. Because of their not high sensitivity, some patients with sinus dysfunction are not recognised; there-after, the diagnosis is only possible, in these cases, on the base of clinical-signs.

Adult↗
PubMed1979

The antibody response in chronic pyelonephritis.

Serum antibodies specific for the bacteria isolated from the urines of 41 patients with chronic pyelonephritis and 14 with asymptomatic bacteriuria were assayed. Even though it is clear that infections which involve the kidney evoke higher antibody responses than do purely bladder infections, it is difficult to establish a cut-off level for distinguishing the two by this method. There is a greater probability that there will be an upper urinary tract infection without an antibody response than that there will be a good antibody response in cases with lower tract infections. In our case list, 49% of the patients with chronic pyelonephritis had titers equal to or greater than 1:400, and another 44% had titers between 1:50 and 1:100. Therefore it appears that the magnitude of the antibody response depends not only on the location of the infection but also on other factors, such as the intrinsic immunogenicity of the different bacterial strains and the properties of the immunological system of the patient.

Adolescent↗