Retrocecal-periappendicular abscess in pregnancy: diagnosis by ultrasound and magnetic resonance imaging.
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Abdominal Abscess↗
Biomedical subjects
L Bonomo
Publications and source records attributed to L Bonomo.
Combined use of the EPA-QUAL2E simulation model and factor analysis to assess the source apportionment of point and non point loads of nutrients to surface waters.
Diffuse pollution is generally indirectly estimated by area and specific emission factors as function of land use. However in many cases these estimates were proven to be remarkably inaccurate. Aim of this study was to combine a water quality simulation model, (USEPA-QUAL2E) and Factor Analysis to increase the understanding of the water pollutants source apportionment. The study concerned two different watersheds, an upland area characterised by a very scarce agricultural use, and another area covering both the upland and the lowland physiographic regions. Particularly the lowland region is included in one of the most productive agricultural areas in Italy. By comparing instream measurements with QUAL2E simulations during dry and wet weather conditions, a good fit (errors +/-20%) was found for the dry weather scenario, whereas very poor was the model performance on the wet weather scenario. This was in the same way expected since the rainfall-driven pollutants scenario deviates significantly from QUAL2E general assumptions of constant emissions in steady state streamflow conditions. However the poor fit was also due to the scarcer reliability of the adopted non point emission estimates. Despite of approximations the model wet weather simulations enabled to estimate the non point contribution to the instream load at the rainfall event scale resolution. Such diffuse sources contribution was found around 80% in the area of extensive agricultural land use, and around 40% in the upland region. Factor Analysis applied to the instream measurements data shed light on the exchange from the groundwater to the surface water system that occurred in the upland region. The hypothesis of a groundwater contribution to the instream total load of nitrates was also supported by QUAL2E simulations that, when considering only the point loads, systematically underestimate the dry weather nitrate concentrations. The same pattern was not observed for the lowland region.
Environmental Monitoring↗
MRI accuracy in residual disease evaluation in breast cancer patients treated with neoadjuvant chemotherapy.
AIM: To assess the accuracy of magnetic resonance imaging (MRI) in evaluating residual disease after neoadjuvant chemotherapy in patients with large breast cancers. MATERIALS AND METHODS: Forty-five women with large breast cancers underwent MRI mammography before and after neoadjuvant chemotherapy (three or six cycles). Dynamic MRI was performed using a 1.5 T unit using three-dimensional FSPGR sequences. For each patient tumour size, tumour volume and dynamic curve were obtained before and after neoadjuvant treatment. Residual tumour sizes obtained using MRI were compared with pathological findings to assess the accuracy of MRI in detecting and in measuring residual tumour. RESULTS: The sensitivity, specificity and accuracy of MRI in detecting residual disease was 90.5, 100, and 91.3%, respectively. The mean of largest diameters measured at histology and at MRI were 26 and 28.2mm, respectively. The tumour size correlation coefficient between MRI and pathology measurements was very high: r(2)=0.9657 (p<0.0001). The interclass correlation coefficient between preoperative imaging measurements and pathological measurements of residual disease was 0.944 (95% CI: 0.906-0.982). CONCLUSION: The presence and size of residual disease in breast patients treated with neoadjuvant chemotherapy could be accurately evaluated using MRI.
Adult↗
The value of the per oral pneumocolon in the study of the distal ileal loops.
AIM: To verify the diagnostic accuracy of per oral pneumocolon in the identification of both normal and pathological patterns in patients with suspected or proven small bowel disease. MATERIALS AND METHODS: Per oral pneumocolon was performed after small bowel follow-through examinations in a series of 42 selected patients. The terminal ileum visibility, the loop location and possible pathological patterns were evaluated separately before and after insufflation. In post-insufflation images the presence/absence of reflux and grade of reflux were evaluated. RESULTS: The diagnostic quality of per oral pneumocolon as compared with per oral small bowel examination was superior in 23 of the 42 patients (54.8%; group 1), similar in nine of the 42 (21.4%; group 2), and inferior in 10 of the 42 (23.8%; group 3). Transvalvular reflux was present in 22 of 23 (95.6%) patients from group 1 and only in one of 10 patients (10%) from group 3 (p<0.001: statistically significant difference). Among the 24 of 42 (57.1%) patients with suspected or proven Crohn's disease, per oral pneumocolon increased the confidence with which the ileum was considered normal in 12 patients and it allowed a better evaluation of the disease extent and the differentiation between prolonged spasms and stenosis in five patients. CONCLUSION: In conclusion per oral pneumocolon should be performed after a small bowel follow-through examination in selected patients.
Adult↗
Computed tomography imaging of vena cava filter complications: a pictorial review.
Caval filters are widely used in the prevention of pulmonary embolism. Filters have proved to be effective, but the complication rate is not negligible. Computed tomography (CT) provides a complete evaluation of the filter, including both caval and extracaval complications. In this review, we describe the normal CT aspect of cava filters, the classification of complications and their CT findings. Technical considerations for adequate CT imaging are also highlighted.
Humans↗
Bench scale evaluation of soil washing for heavy metal contaminated soil at a former manufactured gas plant site.
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Arsenic↗
Superficial inflammatory and primary neoplastic lymphadenopathy: diagnostic accuracy of power-doppler sonography.
OBJECTIVE: To evaluate the sensitivity, specificity and diagnostic accuracy of a cut-off of the resistive index of 0.5 for the differentiation between inflammatory and neoplastic primary lymphadenopathies. SUBJECTS AND METHODS: We measured the resistive index of superficial enlarged lymph nodes in a total of 50 patients (29 males and 21 females; age range 12-72 years, mean age 41.6 year) using an ATL 5000 HDI. A resistive index greater than or equal to 0.5 indicated an inflammatory lymph node and a resistive index <0.5 was consistent with neoplastic primary lymphadenopathies. The gold standard was either surgical biopsy or lymph-node reduction seen with ultrasound examination after antibiotic therapy. RESULTS: The sensitivity of the resistive index for distinguishing inflammatory from neoplastic lymphadenopathy was 84.6%, the specificity 100% and the diagnostic accuracy 95.7% (P < 0.001, statistically significant). CONCLUSION: The results of this study indicate that power-Doppler using a resistive index cut-off of 0.5 was a valid technique for distinguishing between inflammatory and primary neoplastic lymph nodes in patients with superficial lymphadenopathies.
Adolescent↗
[Laparoscopic cholecystectomy in acute cholecystitis: predictors of conversion to open cholecystectomy and preliminar results].
Inspite of increased technical difficulties and high incidence of conversion to open procedures and complications, laparoscopic cholecystectomy is a well established treatment for acute cholecystitis. In this study we reported our results in patients with acute cholecystitis undergoing laparoscopic cholecystecomy from 1998 to 2003. We found out that laparoscopic cholecystectomy was safe and was carried out with acceptable conversion rate and low morbidity. Predictors of complications were delay of surgery more than 48 hours following the onset of symptoms, leucocytosis > 15.000 U/microl and gallbladder wall ultrasonography thickness > 7mm.
Acute Disease↗
Indications to chest radiograph in preoperative adult assessment: recommendations of the SIAARTI-SIRM commission.
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Adult↗
Feasibility study to upgrade a textile wastewater treatment plant by a hollow fibre membrane bioreactor for effluent reuse.
A pilot plant membrane bioreactor has been tested in parallel with a full-scale activated sludge wastewater treatment plant fed on the wastewater from a textile factory. The possibility to upgrade the final effluent for internal reuse was investigated. The pilot and full-scale plants are located in a textile factory (Boselli & C., Olgiate Comasco, North Italy) which manufactures and finishes polyester fabric. The activated sludge wastewater treatment plant (WWTP) is an extended aeration system. The MBR pilot plant is a ZW-10 bench hollow fibre module (membrane surface area: 0.93 m2) submerged in a 200 L tank. Performance and operation of the membrane bioreactor (MBR) were evaluated in terms of permeate characteristics and variability (COD, colour, total N and P, microbiological counts), of membrane specific flux (l m(-2) h(-1) bar(-1)) and other operational parameters (sludge growth and yield).
Bioreactors↗
Non-invasive angiography of the coronary arteries with multislice computed tomography: state of the art and future prospects.
Until now conventional angiography has represented the only technique for assessing the coronary arteries. During the last decade, attempts have been made to validate a non-invasive technique for the study of coronary arteries. In particular, Electron-beam Tomography and Magnetic Resonance Imaging have been used for this purpose, even though they have not become clinical tools. More recently, spiral computed tomography (CT) technology, improved by the use of multiple slices and 500ms gantry rotation times, has shown a good potential without entering routine clinical practice. The introduction of multislice technology with 16 rows and rotation times below 500ms has yielded such good results in detecting significant (>50%) coronary artery stenosis that it has been proposed as a clinical tool. This paper describes the examination technique and the results achieved in CT angiography of the coronary arteries.
Coronary Angiography↗
Topographic organization of the human primary and secondary somatosensory cortices: comparison of fMRI and MEG findings.
We studied MEG and fMRI responses to electric median and tibial nerve stimulation in five healthy volunteers. The aim was to compare the results with those of a previous study using only fMRI on the primary and secondary somatosensory cortices in which the somatotopic organization of SII was observed with fMRI. In the present work we focus on the comparison between fMRI activation and MEG equivalent current dipole (ECD) localizations in the SII area. The somatotopic organization of SII was confirmed by MEG, with the upper limb areas located more anteriorly and more inferiorly than the lower limb areas. In addition a substantial consistency of the ECD locations with the areas of fMRI activation was observed, with an average mismatch of about 1 cm. MEG ECDs and fMRI activation areas showed comparable differences in SI.
Adult↗
Maximum intensity projection analysis in magnetic resonance of the breast.
The aim of this study was to determine the sensitivity, specificity and accuracy of vascular asymmetries and vessel location seen using MR Maximum Intensity Projection imaging for malignant and benign lesions. We enrolled 101 women, with an age ranging from 29 to 69 years (mean age of 53.1 years), with a mammary nodule and candidate for surgical intervention. MR was carried out using a 1.5 Tesla superconductive magnet, equipped with a double and bilateral Phased Array dedicated coil. All images obtained were processed using MIP. The relationship between an asymmetry due to a greater amount of vascular structures in the breast with a malignant neoplasm and symmetry with benign neoplasms were statistically significant (p < 0.001): sensitivity of 71.8%, specificity 100% and accuracy 76.2%. The relationship between perilesional or intralesional vessels with malignant versus benign neoplasms were statistically significant (p < 0.001): sensitivity 88.5%, specificity 82.6% and accuracy 87.1%. We concluded that asymmetries between breasts and the presence of perilesional or intralesional vessels seen in MIP images are important signs and, therefore, must be reported.
Adult↗
Magnetic resonance of the breast: correlation between enhancement patterns and microvessel density in malignant tumors.
The continuous growth of a solid tumor is contingent upon the induction and formation of new vascular structures (angiogenesis). Several studies have established a close correlation between the microvessel density (MVD) of a tumor and its growth capacity. Therefore, a non-invasive method to accurately assess tumor MVD in vivo would be clinically useful. We studied 20 consecutive patients (age range: from 39 to 78 yrs; average age: 58.9 yrs), with malignant breast neoplasms using dynamic MR examinations with a paramagnetic contrast agent and post-operative pathological evaluation. We found that the differences in dynamic MRI enhancement are a direct consequence of microvascular distribution within the neoplasm. This study did not yield a statistically significant correlation between high microcirculation neo-formation and high aggressiveness of the neoplasm, but did indicate that further studies with a larger study populations are necessary.
Adult↗
The Italian multi-centre project on evaluation of MRI and other imaging modalities in early detection of breast cancer in subjects at high genetic risk.
This report presents the preliminary results of the first phase (21 months) of a multi-centre, non-randomised, prospective study, aimed at evaluating the effectiveness of contrast-enhanced magnetic resonance imaging (MRI), X-ray mammography (XM) and ultrasound (US) in early diagnosis of breast cancer (BC) in subjects at high genetic risk. This Italian national trial (coordinated by the Istituto Superiore di Sanità, Rome) so far recruited 105 women (mean age 46.0 years; median age 51.0; age range 25-77 years), who were either proven BRCA1 or BRCA2 mutation carriers or had a 1 in 2 probability of being carriers (40/105 with a previous personal history of BC). Eight cases of breast carcinomas were detected in the trial (mean age 55.3 years, median age 52.5; age range 35-70 years; five with previous personal history of BC). All trial-detected BC cases (8/8) were identified by MRI, while XM and US correctly classified only one. MRI had one false positive case, XM and US none. Seven "MRI-only" detected cancers (4 invasive, 3 in situ) occurred in both pre- (n = 2) and post-menopausal (n = 5) women. With respect to the current XM screening programmes addressed to women in the age range 50-69 years, the global incidence of BC in the trial (7.6%) was over ten-fold higher. The cost per "MRI-only" detected cancer in this particular category of subjects at high genetic risk was substantially lower than that of an XM-detected cancer in the general women population. These preliminary results confirmed that MRI is a very useful tool to screen subjects at high genetic risk for breast carcinoma, not only in pre-, but also in post-menopausal age, with a low probability of false positive cases.
Adult↗
A structural and theoretical analysis of transition metalloporphodimethenes and their relationship with metalloporphyrins.
The paper reports the synthesis of the first-row transition metal hexaethylporphodimethene derivatives [(Et6N4)M] [M=Mn, 3; M=Co, 5; M = Cu, 7] on a multigram scale, which makes them easily available for reactivity studies. After synthesis they were converted into the corresponding five-coordinate [(Et6,N4)M(L)] [M = Mn, L =THF, 8; M =Co, L = Py, 9] and six-coordinate [(Et6,N4)M(L)2] [M = Mn, L = THF, 10; M = Mn, L = Py, 11] derivatives. The compounds mentioned above and those recently reported, namely the iron and nickel derivatives 4, 6, 12, and 13, permit the presentation of the first coherent report on the structural, optical, magnetic, and electronic characteristics of the first-row transition metal porphodimethene derivatives. The experimental results, coupled with a detailed theoretical analysis (Density Functional Theory, DFT), give the appropriate background for future development of the porphodimethene skeleton, which paves the way from porphyrinogen to porphyrins. In addition, this report, encompassing the entire first row of transition metal ion porphodimethenes, allows a valuable comparison to be made with the corresponding metallated porphyrins, thus establishing the peculiar differences in terms of structural and electronic properties and potential reactivity.
Crystallography, X-Ray↗
The pi complexation of alkali and alkaline earth ions by the use of meso-octaalkylporphyrinogen and aromatic hydrocarbons.
The full metallation of meso-octaalkylporphyrinogens [R8N4H4] (R=Et, 1; nBu, 2; CH2Ph, 3; (CH2)4, 4) with heavy alkali metals (M = K, Rb, Cs) leads to the porphyrinogen-M4 compounds, in which the solvation of the alkali cations is largely assured by the intra- and intermolecular phi-interactions with the pyrrolyl anions. Such a mode of complexation results in a structural diversity as a function of the meso substituents, the size of the metal ion, and the solvent. The structure of the unsolvated polymers [R8N4M4]n (R= Et, M=K, 5; M=Rb, 6; M=Cs, 7; R= (CH2)4, M = Rb, 8; M = Cs, 9) have been clarified through the X-ray analysis of 7 recrystallized from diglyme. The structure shows that the tetraanion binds two Cs ions inside the cavity, which display in one case eta1:eta1:eta1:eta1 and in the other eta5:eta5:eta5:eta5 interaction modes. Bidimensional polymerization is assured by four Cs ions, which each bind at the eta5 position on the exo face of each pyrrole. With bulkier meso substituents, different polymeric forms are obtained (R = nBu, M = K, 10; M = Rb, 11; M = Cs, 12), and their structures were clarified through the X-ray analysis of 10, which was recrystallized from dimethoxyethane. The polymeric units are made up by the monomeric units [Bu8N4K2]2-, in which one potassium is eta1:eta1:eta1:eta5 and the other eta5:eta1:eta5:eta1 bonded inside the porphyrinogen cavity. In the case of R=CH2Ph, the monomeric anion [(PhCH2)8N4K2]2- (13) has been structurally identified. The metallation of 1 and 2 with active forms of alkaline earth metals (M' = Ca, Sr, Ba) led to dinuclear compounds [R,N4M'2] (R = Et, M' = Ca, 14; M'=Sr, 15; M'=Ba, 16; R=nBu. M'=Ba, 18), in which both metals inside the cavity are eta1:eta3:eta1:eta3 (Ca) and eta1:eta5:eta1:eta5 (Sr and Ba) bonded to the porphyrinogen tetraanion. The coordination sphere of each metal ion is completed by two THF molecules, which, in the case of Ba, are easily replaced by an arene ring [Bu8N4Ba2(eta6-arene)2] (arene=durene, 22; naphthalene, 23; toluene, 24; benzene, 25). The X-ray structures of 14, 15, 18, 22, and 23 are described in detail. We have tried to establish a relationship between the solid-state and solution structures by analyzing the 1H NMR spectra of the porphyrinogen complexes.
Journal Article↗
Diagnostic utility of an echo-contrast agent in patients with synovitis using power Doppler ultrasound: a preliminary study with comparison to contrast-enhanced MRI.
The purpose of this study was to first evaluate Levovist (Schering, Berlin, Germany), an echo-contrast agent, during power Doppler sonography (PDS) in patients with synovitis using asymptomatic joints as controls. Then we evaluated the accuracy of this technique against contrast-enhanced MRI. Forty patients (19 men and 21 women; mean age 40 years) were enrolled on the basis of clinical signs, laboratory tests, and radiographic findings positive for articular inflammatory disease. They were examined with conventional ultrasonography (US) and PDS techniques before and after intravenous contrast medium injection. Fourteen patients then underwent MRI with and without contrast medium 8-14 days after PDS studies. Three expert readers independently evaluated each examination. After contrast medium, synovium in inflammatory arthritis enhanced on PDS compared with normal joints in the same patient. Power Doppler sonography after contrast medium and MRI were concordant in all cases. Power Doppler sonography with contrast medium showed a qualitative increase in signal from synovial vessels, the first sign of synovial changes in inflammatory diseases.
Adolescent↗