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Biomedical subjects

G Puppini

Publications and source records attributed to G Puppini.

16 recordsLinked to original sources

Characterisation of carotid atherosclerotic plaque: comparison between magnetic resonance imaging and histology.

PURPOSE: The aim of this study was to identify and characterise by magnetic resonance imaging (MRI) carotid plaque constituents such as lipid-rich necrotic core, intraplaque haemorrhage and calcification in patients treated with carotid endarterectomy (CEA) using histological evaluation as the reference standard. MATERIALS AND METHODS: Nineteen patients (13 men and six women) scheduled for CEA between March and August 2004 were imaged on a 1.5-T scanner (Magnetom Symphony, Siemens, Erlangen, Germany). The protocol included four types of sequences [T1, T2, proton density (PD) and three-dimensional time of flight (3D-TOF)]. Images were reviewed for integrity of the fibrous cap, presence of lipid-rich necrotic core, intraplaque haemorrhage and calcification. Signal intensity was assessed relative to the adjacent sternocleidomastoid muscle. Four cross-sections for each lesion were compared with the corresponding histological specimens and independently reviewed by two radiologists and one pathologist. RESULTS: MRI detected lipid-rich necrotic core with a sensitivity and specificity of 91.6% and 95.0%, respectively, whereas it defined intraplaque haemorrhage alone with a sensitivity and specificity of 91.6% and 100%, respectively. Calcification was recognised with a sensitivity and specificity of 80% and 93.7%, respectively. CONCLUSIONS: MRI is able to identify signs of carotid plaque instability with a high sensitivity and specificity. Therefore, it may be useful in evaluating and guiding the treatment of haemodynamically nonsignificant stenoses with a potential embolic risk and, in the future, to assess coronary plaque.

Aged↗

Does the tuberous sclerosis complex include intracranial aneurysms? A case report with a review of the literature.

BACKGROUND: Tuberous sclerosis is a protean, genetically determined disease that may involve any organ or tissue and lead to a great number of symptoms and clinical features. OBJECTIVE: Diagnosis can be very difficult in cases with incomplete manifestations (formes fruste) lacking the classic signs of the disease. MATERIALS AND METHODS: We report a case fulfilling the diagnostic criteria for tuberous sclerosis (shagreen patches, hypomelanotic macules, renal cysts and angiomyolipomas, and "migration tracts" in the cerebral white matter) in association with a giant intracranial aneurysm, but lacking mental retardation, epilepsy and facial angiofibroma. RESULTS: Fourteen other cases of tuberous sclerosis and intracranial aneurysms, all but one without any clear sign of polycystic kidney disease, were found in the literature. CONCLUSION: We suggest that vascular dysplasias in general and aneurysms (mainly intracranial) in particular can be added to the other non-primary diagnostic features for the clinical diagnosis of tuberous sclerosis.

Abnormalities, Multiple↗

Motor representation of the hand in the human cortex: an f-MRI study with a conventional 1.5 T clinical unit.

The purpose of this study was to show a gradient of possible bilateral activation for movements of the non-dominant vs. dominant hand, as well as for areas involved in complex vs. simple hand movements. A standard 1.5 T magnetic resonance imaging (MRI) system has been utilized to localize the cortical motor hand areas, using the blood oxygen level dependent contrast (BOLDc) technique and single-section fast low-angle shot (FLASH) imaging. Ten normal right-handed subjects volunteered for the study. The motor tasks consisted of simple (flexion-extension) finger movements of either hand, and complex movements (finger-to-thumb opposition in a repeating, pre-planned sequence) of the non-dominant hand. Simple movements caused contralateral activation of the primary motor area (MA); ipsilateral activation was observed for the non-dominant hand only. Supplementary motor area (SMA) was also activated, with a clear contralateral prevalence. The ratio of bilateral activation of MA did not change with complex movements of the non-dominant hand, while SMA as well as lateral premotor area were largely bilaterally activated in this task. In conclusion, the ipsilateral MA is activated for movements--even simple--performed with the non-dominant hand. There is widespread functional activity, involving both contralateral and ipsilateral SMA, for complex movements.

Adult↗

Spike topography and functional magnetic resonance imaging (fMRI) in benign rolandic epilepsy with spikes evoked by tapping stimulation.

We performed a spike topography study and a functional magnetic resonance imaging (fMRI) in a female patient with benign rolandic epilepsy presenting single high-amplitude evoked spikes in response to somatosensory peripheral stimulation. The stimulus was delivered to the first finger of the right hand using a tendon hammer, which evoked a single spike followed by a slow wave, showing the maximal amplitude over the left central regions. fMRI showed that the contralateral sensory cortices (S1 and S2) and the motor cortex (M I) were activated during tapping stimulation. In 3 normal subjects, tapping stimulation produced no fMRI activation. This fMRI study documents a highly focal activation of sensorimotor areas related to subclinical evoked spikes in benign rolandic epilepsy.

Acoustic Stimulation↗

Fossa navicularis magna.

A notchlike bone defect in the basiocciput due to a prominent fossa navicularis was incidentally discovered in a patient referred for radiologic evaluation of sinusitis. MR images showed that the osseous defect was filled with lymphoid tissue of the pharyngeal tonsil. The occurrence of this anatomic variant is discussed, with reference to ancient anatomic works.

Adult↗

Comparison between manual and automatic coding of medical record statistical cards at a university hospital.

The coding error rate of systems for medical record statistical cards (MRSCs) throughout health services is about 30%. A program using automatic coding has been developed at the Institute of Clinical Surgery II, Padua University Hospital, with a view to reducing this percentage. Out of an overall sample of 4776 MRSCs from all departments of the hospital, 54 were automatically coded at our institute. Categories of discrepancy between the discharge diagnosis codes of the 4722 manually coded MRSCs and the other 54 MRSCs were classified as follows: types I-III, diagnosis assigned to an erroneous under-class, class or heading (ICD-9) respectively; type IV, incorrect diagnosis formulation precluding code assignment; type V, two or more discrepancies on MRSC; and type VI, secondary diagnosis not coded. Discrepancy rates were as follows: 22.3% and 0.0% for type I; 21.3% and 0.0% for type II; 17.6% and 0.0% for type III; 1.9% and 0.0% for type IV; 5.8% and 0.0% for type V; 31% and 1.9% for type VI. Code discrepancy rates for surgical procedures, which were also compared, ranged from 7.0 to 12.5% for manual coding, while no discrepancy was observed in automatically-coded MRSCs. The results clearly demonstrate the utility of the system reported on, and it is suggested that it should be used in a modified form in other hospital departments.

Abstracting and Indexing↗