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Biomedical subjects

L Bocchi

Publications and source records attributed to L Bocchi.

At least 19 recordsLinked to original sources
PubMed2006

Shape analysis of microcalcifications using Radon transform.

Microcalcifications are one of the early signs of breast cancer, and they are of great importance for an early diagnosis. Moreover, the spatial distribution and the shape of the microcalcifications have a significant impact in medical practice to evaluate the probability of malignancy of the tumor. In this work a method, performing computer-aided classification of the shape of calcifications accordingly to the classification scheme proposed by Le Gal, is presented. In the first stage, in order to remove mammographic background, the image is preprocessed with a matched filter, designed by modeling the microcalcifications as Gaussian spots and the image as a Fractional Brownian Motion. Afterwards, morphology of spots has been evaluated using two different sets of parameters. The first set utilizes the moments of inertia of the second and third order to compute a set of features, which are invariant to rotations and translations of the image. The second set of parameters is derived from the evaluation of the Radon transform, as computed along eight axes. The results of the Radon transform are used to associate to each lesion a set of features, which are invariant to rotation and scaling of the image. In the final stage, a multilayer neural network has been used to assign each microcalcification to the classes introduced by Le Gal. The topology of the neural network is the same for both sets of descriptors, in order to allow comparison of the discriminative power of the two feature sets. Experimental results obtained with the proposed method from a set of digitized mammograms are reported and discussed.

Algorithms↗
PubMed2004

Detection of single and clustered microcalcifications in mammograms using fractals models and neural networks.

Microcalcifications (microCas) are often early signs of breast cancer. However, detecting them is a difficult visual task and recognizing malignant lesions is a complex diagnostic problem. In recent years, several research groups have been working to develop computer-aided diagnosis (CAD) systems for X-ray mammography. In this paper, we propose a method to detect and classify microcalcifications. In order to discover the presence of microCas clusters, particular attention is paid to the analysis of the spatial arrangement of detected lesions. A fractal model has been used to describe the mammographic image, thus, allowing the use of a matched filtering stage to enhance microcalcifications against the background. A region growing algorithm, coupled with a neural classifier, detects existing lesions. Subsequently, a second fractal model is used to analyze their spatial arrangement so that the presence of microcalcification clusters can be detected and classified. Reported results indicate that fractal models provide an adequate framework for medical image processing; consequently high correct classification rates are achieved.

Algorithms↗
PubMed2002

Compression hip screw nail-plate system for intertrochanteric fractures.

BACKGROUND: The worldwide increased incidence in fractures of the proximal end of the femur is increasing with the parallel increase in the average age of the population. The advanced age and poor physical condition of these patients render surgery necessary. METHODS: In 1999, at the Orthopaedic Clinic of the University of Siena, 56 patients were treated with the compression hip nail-plate system, a new synthesis device for the treatment of peritrochanteric fractures. The system consists of a new dynamic cephalic screw that could be combined with a plate or a femoral nail. The dynamic cephalic screw of the BCM system has a limited sliding method, impeding excursions greater than 10 mm and preventing excessive collapse of the fracture fragments that can evolve into a shortening of the limb. The canulated nail has a diameter of only 9 mm, which permits insertion into the shaft canal without reaming. RESULTS: Four patients with a follow-up of less than 3 months, 2 patients lost to control, and 1 patient who died were excluded from the study. All 49 remaining patients healed clinically and radiographically within 3 months. CONCLUSIONS: The possibility of the double combination of the screw with a plate or with an intramedullary nail permits the surgeon to have a double solution with a single instrument at hand, and offers the opportunity of changing the choice of synthesis method to implant even during surgery.

Aged↗
PubMed2001

Social stress, myocardial damage and arrhythmias in rats with cardiac hypertrophy.

In rat models of cardiac hypertrophy (moderate aortic coarctation: ACm, n=18; severe aortic coarctation: ACs, n=27; aging: OLD, n=25; spontaneous chronic hypertension: SHR, n=18) and properly matched control animals (C(ACm), n=17; C(ACs), n=19; C(OLD), n=24; C(SHR), n=22), we investigated the relative contribution of intense autonomic activity and cardiac structural damage to ventricular arrhythmogenesis. We used an "in vivo" to tissue level approach, by correlating in the same animal: (i) social stress-induced ventricular arrhythmias, telemetrically recorded, and (ii) left ventricular weights (LVW) and amount and geometrical properties of myocardial fibrosis (MF). Arterial blood pressure was significantly higher in ACm (+11%), ACs (+28%) and SHR (+34%) than in controls. LVW were approximately 20% greater in ACm, ACs and OLD and 50% greater in SHR. MF was about twice as great and characterized by more frequent occurrence of microscopic scarring in ACm and ACs, and eight times greater and associated with both a higher number and a larger size of fibrotic foci in OLD and SHR compared to controls. Social stress increased ventricular arrhythmia vulnerability in all models of cardiac hypertrophy, as well as in controls. The arrhythmogenic action of stress was facilitated in ACs, OLD and SHR. A correlation between structural cardiac remodeling and ventricular arrhythmias was found only in SHR and OLD, which exhibited the greatest increase in LVW and/or MF. Social stress proved to be a valuable tool for analyzing the combined effects of autonomic stimulation and altered myocardial substrate on the genesis of potentially life-threatening arrhythmias in social animals.

Aging↗
PubMed2000

A new method of repair for quadriceps tendon ruptures. A case report.

Rupture of the quadriceps tendon is an uncommon injury observed predominantly in subjects over 40 years old. Multiple surgical techniques have been employed to repair fresh and neglected ruptures; methods that make use of allograft and augmentation with tissues harvested from around the knee have been reported. We describe a case of surgical repair of a tendon-bone junction rupture in a 64-year-old patient by use of suture anchors to attach the tendon to bone and improve fixation of the soft tissue elements. Clinical diagnosis of rupture was confirmed radiographically and echographically. Surgical repair was performed within 24 hours of injury. Active movement of the knee started after 3 weeks and the patient was permitted to walk without weight-bearing with a knee cage. Three weeks later, he was permitted to walk with full weight-bearing unassisted by crutches; the knee cage was removed 6 weeks after surgery. At his most recent follow-up 24 months postoperative, quadriceps strength was equal to that of the controlateral knee and the patient has returned to sports and daily activities. The surgical method presented here provides a suture of the tendon ends without putting excess stress on the suture line during the period of early knee mobilization. Advantages over other techniques include reduced operative time, easy access to the implantation site, and better resistance of the suture material: the patient is thus able to initiate physical therapy earlier and more aggressively.

Humans↗
PubMed1997

Tissue characterization from X-ray images.

The study of the fine-scale structure of biological tissues is crucial for diagnosing a wide number of different diseases. In X-ray images, fine structures usually induce a correlation among image gray levels and are commonly perceived as textures. In this paper, we report on a Computer Vision approach to the characterization of biological tissues as imaged by standard X-ray techniques. In particular, using features derived from co-occurrence matrices, we have assessed spatial gray-level dependence of bone tissue and lung parenchyma images. A hybrid neural network was adopted to distinguish pathological tissues from normal ones and to classify different pathologies.

Bone Diseases↗
PubMed1996

Comparison of the antiinflammatory efficacy of chondroitin sulfate and diclofenac sodium in patients with knee osteoarthritis.

OBJECTIVE: To assess the clinical efficacy of chondroitin sulfate (CS) in comparison with the nonsteroidal antiinflammatory drug (NSAID) diclofenac sodium (DS) in a medium/longterm clinical study in patients with knee osteoarthritis (OA). METHODS: This was a randomized, multicenter, double blind, double dummy study. 146 patients with knee OA were recruited into 2 groups. During the first month, patients in the NSAID group were treated with 3 x 50 mg DS tablets/day and 3 x 400 mg placebo (for CS) sachets; from Month 2 to Month 3, patients were given placebo sachets alone. In the CS group, patients were treated with 3 x 50 mg placebo (for diclofenac) tablets/day and 3 x 400 mg CS sachets/day during the first month; from Month 2 to Month 3, these patients received only CS sachets. Both groups were treated with 3 x 400 mg placebo sachets from Month 4 to Month 6. Clinical efficacy was evaluated by assessing the Lequesne Index, spontaneous pain (using the Huskisson visual analog scale), pain on load (using a 4 point ordinal scale), and paracetamol consumption. RESULTS: Patients treated with the NSAID showed prompt and plain reduction of clinical symptoms, which, however, reappeared after the end of treatment; in the CS group, the therapeutic response appeared later in time but lasted for up to 3 months after the end of treatment. CONCLUSION: CS seems to have slow but gradually increasing clinical activity in OA; these benefits last for a long period after the end of treatment.

Acetaminophen↗
PubMed1995

Titanium anchors for the repair of rotator cuff tears: preliminary report of a surgical technique.

We used titanium anchors for the surgical repair of rotator cuff tears in 34 selected patients, all of whom were < 60 years of age, had good bone quality, and had no known metabolic bone diseases. Nine tears were repaired within 6 months, 15 within 6-12 months, and 10 later than 12 months after injury. Tear size was graded as small (10 patients), medium (15 patients), and large (nine patients) during open operation. After 6-24 months of follow-up, 30 patients reported satisfactory pain relief, function, active forward flexion, and muscle strength [18 excellent and 12 good results based on the University of California at Los Angeles rating system (UCLA scores)]; there were no implant failures (p < 0.001). Two patients had unsatisfactory function but good relief of pain, whereas two patients were dissatisfied with their overall result (four poor results based on UCLA scores). Although trans-bone suturing is presently the most common and successful surgical technique for rotator cuff tears, we found that use of titanium anchors shortens operative time and has results comparable with the traditional technique. Titanium anchors should not be used when bone quality is poor or good patient compliance is doubtful. They are also contraindicated, as our four poor results indicate, when the tear is old (> 6 months) and large (diameter > 5 cm with significant tissue degeneration).

Adult↗
PubMed1995

The diagnosis of acute complete tears of the anterior cruciate ligament. Comparison of MRI, arthrometry and clinical examination.

We reviewed 38 patients with arthroscopically-proven complete ACL tears operated on less than three weeks after injury. Their average age was 26 years (16 to 43), with 27 males and 11 females. All patients had had MRI preoperatively. The same examiner performed the Lachman, anterior-drawer, and pivot-shift tests without anaesthesia, recording the differences between the injured and the normal knees. The patients then had KT-1000 arthrometry by the same examiner at 15 lb (6.8 kg) and 20 lb (9 kg), with active displacement, and with maximum manual displacement. All scored positive for differences greater than 3 mm. The results of physical examination, KT-1000 tests and MRI were analysed using McNemar's test for matched data with continuity correction and a 95% confidence interval for each test. The sensitivity of the KT-1000 manual maximum test was 97% for 3 mm and 100% for 2 mm; this was the most useful arthrometric result. The Lachman test gave 95% sensitivity, providing the best simple clinical assessment. MRI was 97% sensitive for the detection of all ACL injuries, but this fell to 82% with respect to complete rupture. We found no significant differences between the results of the Lachman test and the KT-1000 manual maximum test, but these were significantly better than all other tests. In an era of cost-containment, we have shown that inexpensive tests in the clinic can allow treatment to proceed rapidly and in the most economical manner without the routine use of MRI.

Acute Disease↗
PubMed1994

Meniscal ossicles: two case reports and a review of the literature.

Intrameniscal ossicles of the knee are rare lesions. We present two cases. The first case occurred in a male soccer player who had knee trauma, with radiographic findings of a meniscal ossicle. Meniscal motions were normal, and symptoms resolved with conservative measures. The second case was found in a male athlete with acute medial compartment instability and complex meniscal tears. His medial meniscus, containing the ossicle, was removed. Initial conservative management is recommended for all cases of meniscal ossicle, and arthroscopic resection of the ossicle is recommended for symptomatic cases.

Adult↗
PubMed1994

Partial lateral meniscectomy in athletes.

Arthroscopic partial lateral meniscectomies performed for isolated meniscal tears, without associated ligamentous injury, in 41 athletes between August 1, 1988 and June 1, 1991 were reviewed for clinical and functional outcome. The study population was composed of 27 males and 14 females, with an average age of 26 years (range 17-40). Thirty-seven patients (90%) reported previous trauma to the knee. At an average follow-up of 3 years (range 2-5), 85% of the patients had excellent/good results, and 98% of the athletes returned to full sports activities after an average of 55 days. Patients' prognoses depended on (a) type of meniscal tear and (b) presence/absence of an articular cartilaginous lesion. Athletes who had isolated, longitudinal type tears of the lateral meniscus had the best outcome: 100% achieved excellent/good results and averaged 41 days to return to full sports activities. Athletes with complex meniscal tears and tears associated with articular cartilaginous lesions had the poorest results, achieving 79% and 64% excellent/good results, respectively, and averaging 64 and 78 days, respectively, for return to full sports activities.

Adolescent↗
PubMed1993

Trends in the incidence of hip fracture in Siena, Italy, from 1980 to 1991.

There is general agreement that the crude incidence of proximal femur (hip) fractures is rising in conjunction with the ageing of the underlying population. To explore possible changes in hip fracture incidence over time we analysed all femoral fractures occurring in the county of Siena from 1980 to 1991. Data were collected from hospital record charts of the Department of Orthopaedics, recording all hip fractures occurring during the 12-year period. In this period, the mean resident population in Siena was 238,369 inhabitants (aged 0 to 90+ years) and the crude number of all femoral fractures was 2,238. However, in calculating incidence rates, only hip fractures occurring in the population aged over 50 years were considered. In this population, the number of hip fractures was 1,825 with a male/female ratio of 1:2.8. A time-series data analysis (temporal trend) of the incidence of hip fracture during the 12-year period revealed a linear and significant (p < 0.001) trend to increase, but only in males, with an annual increasing rate of 3.62 per 100,000 person-years. In the female population, the temporal analysis did not show any significant trend during the observation period.

Adolescent↗
PubMed1991

The Onik method of automated percutaneous lumbar diskectomy (A.P.L.D.). Criteria of selection, technique, and evaluation of results.

The Onik method of automated percutaneous lumbar diskectomy is a new type of percutaneous surgery for the treatment of herniated lumbar disk. Candidates for this procedure should be carefully evaluated on the basis of precise clinical criteria and instrumental diagnosis. The goal is to select patients in whom excellent results can be achieved, recognizing the limitations as well as the merits of the technique. The surgical approach is described and the potential difficulties are discussed, since this technique must be performed with precision and without trauma in order to obtain good results. The clinical results of 500 patients treated by the Onik method of automated percutaneous lumbar diskectomy are reported. The follow-up period ranged from 6 months to 2 1/2 years. The patients were divided into three groups according to the strength of the indication for A.P.L.D.; the quality of the result is reported for each group.

Adult↗
PubMed1988

The surgical treatment of metastases in long bones.

The authors report their experience in the treatment of metastases in long bones. Between 1980 and 1985, 51 cases were submitted to surgical treatment. They comprised osteolytic lesions in the femur (44), tibia (2), and humerus (5). The most frequent primary tumours were: carcinoma of the breast (37%), lung (25%), kidney (16%), rectum (9%). The remaining 13% were from the prostate gland, bladder, ovaries, uterus, chronic lymphatic leukemia, and haemangiopericytoma. Surgical treatment was supplemented by medication and physiotherapy. The choice of instrumentation (prosthesis, total prosthesis, plates, endomedullary nailing) was based on the site of the metastasis and the general condition of the patient. Palliative surgery in these cases was fully justified by the results in that it achieved the aim we set ourselves, namely to restore these unfortunate patients to as normal a lifestyle as possible.

Adult↗
PubMed1987

Atherosclerosis of the vessels in the ligamentum teres. Optical and electron microscopy findings in elderly patients with femoral neck fractures.

The ligamentum teres was studied in 20 subjects, aged from 64 to 83 years, with fractures of the femoral neck treated by prosthetic replacement during 1985. The arterioles were examined under a stereoscopic dissection microscope; they were further studied by optical and electron microscopy. Almost complete occlusion by typical proliferative atherosclerotic changes was a constant finding, thereby cutting off any significant vascular supply to the femoral head.

Aged↗
PubMed1985

Atherosclerosis of the microcirculation in the femoral head: based on a study by optical and electron microscopy of femoral heads removed at operation.

The authors studied 56 femoral heads removed at operation, using dissection stereoscopic microscopy and electron microscopy. They were able to demonstrate atherosclerotic lesions involving the microcirculation in the femoral head. Atheromatous changes in the external iliac and profunda femoris arteries have already been documented, but similar changes in the small vessels within the femoral head have not previously been noted in the literature.

Adult↗
PubMedDate not supplied

A simple modified arthroscopic procedure for fixation of displaced tibial eminence fractures.

SUMMARY: Avulsion fractures of the tibial eminence have been well described in children and adults with an increased in incidence resulting from road traffic and athletic accidents. According to the literature, only surgical treatment is advocated because of the high incidence of the nonunion and instability following conservative treatment. Open reduction can cause some morbidity and, therefore, arthroscopic techniques have been developed. The limitations of the techniques are related to technical difficulty and unstable fixation. We report a simple and effective method of fixation with the following advantages: (1) use of metallic suture for stable fixation, (2) the fixation device is easily removed in the office, (3) there is no need of additional instruments, and (4) the minimal size of the fixation device avoids damage to the anterior cruciate ligament insertion. This technique has been used in a series of 10 consecutive patients treated for avulsion fractures of the tibial spine since 1991, resulting in a high rate of excellent and good results without any case of nonunion fracture or related complication.

Adult↗