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L Celentano

Publications and source records attributed to L Celentano.

At least 19 recordsLinked to original sources
PubMed2001

Abnormalities of renal endothelin during acute exacerbation in chronic obstructive pulmonary disease.

Circulating and urinary levels of endothelin (ET), an endothelium-derived vasoconstrictive and mitogenic peptide have been reported to increase in patients with chronic obstructive pulmonary disease (COPD), but the mechanisms of these abnormalities are not fully understood. Our study objectives were to evaluate pulmonary and renal ET clearance in COPD patients during an acute exacerbation. Our participants included nine consecutive patients with moderate to severe COPD without signs of right heart failure admitted for acute exacerbation and ten healthy volunteers (HV) as controls. ET was detected by radioimmunoassay in venous and arterial blood as well as in a timed urine specimen. For each subject, arterial/venous immunoreactive ET ratio (ir-ETart/ir-ETven) was evaluated as an index of its pulmonary clearance. Creatinine clearance was employed in each case to obtain a corrected renal ir-ET clearance. Glomerular filtration rate (GFR) was also assessed by dynamic(99m)Tc-diethylenetriamine pentaacetic acid renal scintigraphy in six COPD patients during acute exacerbation and at recovery. The ratio ir-ETart/ir-ETven was comparable in COPD patients (0.75+/-0.12) and in HV (0.82+/-0.09). A significant difference was found with respect to 24 h ir-ET urinary excretion between COPD patients during exacerbation as well as at recovery (respectively 142.1+/-12.8 ng/24 h and 89.0+/-15.1 ng/24 h) and HV (65.1+/-10.1 ng/24 h). ET renal clearance was higher in COPD patients than in HV (29.2+/-5.2 ml min(-1)in COPD during exacerbation; 17.5+/-3.9 ml min(-1)at recovery and 13.6+/-2.4 ml min(-1)in HV, P<0.001). GFR was 69.4+/-10.0 ml min(-1)in COPD patients during exacerbation and it significantly increased at the recovery (95.5+/-20.9 ml min(-1)P<0.001). Corrected renal clearance of the peptide was significantly correlated to GFR values during the exacerbation (r=-0.81, P<0.05). Furthermore change in renal ET production resulted associated with changes in paCO(2)(r=0.83, P<0.001) and in paO(2)(r=-0.73, P<0.05). Acute exacerbation in COPD patients causes an increase in renal ET production which is partially reversible at the recovery, in the absence of significant changes in ET-1 circulating levels. ET might contribute to the renal response to hypoxaemia and hypercapnia in COPD.

Acute Disease↗
PubMed2000

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Journal Article↗
PubMed1999

Colonoscopy and technetium-99m white cell scan in children with suspected inflammatory bowel disease.

OBJECTIVES: To determine the utility of the technetium-labeled autologous white cell scintigraphy (Tc-WCS) for detecting intestinal inflammation in children with suspected inflammatory bowel disease (IBD). Tc-WCS was compared with colonoscopy and histologic examination. STUDY DESIGN: Forty-eight children (26 boys; median age, 10 years; range, 2-17 years) with symptoms and signs suggesting IBD had colonoscopy with exploration of terminal ileum and mucosal biopsies. The scans were judged to be abnormal if activity was seen in the gut within the first hour. RESULTS: Twenty-one patients had a diagnosis of IBD (Crohn's disease, 13; ulcerative colitis, 5; indeterminate colitis, 3); results of scintigraphy were positive in 16 and negative in 5 (sensitivity, 76.2%); the latter had a moderate degree of intestinal inflammation. In 27 patients, IBD was ruled out. Results of scintigraphy were negative in children with non-specific colitis and in those with lymphoid hyperplasia of the terminal ileum, whereas results were positive in 6 of 12 patients with spondyloarthropathy. In children with IBD, there was a significant correlation between results of scintigraphy and endoscopy for the intensity of inflammation (r = 0.70); however, there was a poor correlation regarding the number of involved segments (r = 0.30) because in 16 patients, endoscopy revealed additional diseased segments as compared with scintigraphy. CONCLUSIONS: A positive Tc-WCS result indicates the presence of an inflammatory process of the gut, whereas a negative test result does not rule out intestinal inflammation, especially when the latter is of moderate degree. Colonoscopy and biopsy are the investigations of choice to establish the diagnosis of IBD and are superior to Tc-WCS in assessing topographic extension of IBD.

Adolescent↗
PubMed1999

Measurement of glomerular filtration rate by the 99mTc-DTPA renogram is less precise than measured and predicted creatinine clearance.

The work was devised to compare measurements of glomerular filtration rate (GFR) by technetium-99m-diethylenetriaminepentacetic acid (99mTc-DTPA) renogram to those by creatinine clearance (measured and predicted by Cockroft and Gault) and by inulin clearance. A total number of 65 individuals were enrolled: 15 healthy controls and 50 patients with renal disease. Compared to inulin clearance used as the gold standard, 99mTc-DTPA overestimated at low and underestimated at high GFRs. 99mTc-DTPA measurements were less precise than creatinine clearance except for individuals with GFR >100 ml/min x 1.73 m2. Measured creatinine clearance had the highest correlation coefficient with inulin clearance, 99mTc-DTPA clearance the lowest. In correlation analyses, 81.5% of the interindividual variability for measured creatinine clearance could be explained by true differences in inulin clearance; this value dropped to 59.1 and 57.4% for predicted creatinine clearance and 99mTc-DTPA, respectively. In patients with GFR <25 ml/min x 1.73 m2, all 99mTc-DTPA measurements were out of the 95% confidence interval for the inulin measurement. It can be inferred that 99mTc-DTPA clearance from the renogram is less precise than measured and predicted creatinine clearance.

Adult↗
PubMed1996

Treatment of advanced medullary thyroid carcinoma with a combination of recombinant interferon alpha-2b and octreotide.

BACKGROUND: The medical treatment of advanced medullary thyroid carcinoma (MTC) is still questionable. Results of chemotherapy are disappointing with almost no curative responses, few partial responses, and many side-effects. A recent report has suggested the activity of combination recombinant interferon alpha-2b (rIFN-alpha-2b) and octreotide, a somatostatin analogue, in the treatment of a metastatic carcinoid tumor. This new therapeutic schedule may be used in other neuroendocrine tumors. In this study we evaluated the therapeutic effectiveness of octreotide and rIFN-alpha-2b in patients with advanced MTC. METHODS: Eight patients affected by advanced MTC received octreotide at a daily dose of 150 micrograms for 6 months and subsequently at a daily dose of 300 micrograms for another 6 months, subcutaneously, and rIFN-alpha-2b at a daily dose of 5.000.000 IU intramuscularly 3 times a week for 12 months. Plasma calcitonin, carcinoembryonic antigenic levels, and morphologic staging were evaluated at 0, 1, 3, 6, and 12 months. RESULTS: The therapy was stopped in two patients because of diarrhea and toxicity of drugs used. Pre-existing diarrhea in four patients and flushing in one significantly improved during treatment. A maximum decrease of calcitonin was reached after 1 month in 2 patients and after 3 months in 4. In all of the patients carcinoembryonic antigen levels decreased during treatment. No significant changes of size of metastases were observed. CONCLUSIONS: The combination of octreotide and interferon is well tolerated and can be recommended for the treatment of advanced MTC.

Adult↗
PubMed1996

Early detection of lung involvement in lysinuric protein intolerance: role of high-resolution computed tomography and radioisotopic methods.

Pulmonary disease of unknown etiology is a potentially fatal complication in patients with lysinuric protein intolerance (LPI), an autosomal recessive disorder caused by the defective transport of cationic amino acids. Lung involvement was investigated in nine Italian LPI patients through pulmonary function tests and lung imaging studies consisting of conventional chest radiography, high-resolution computed tomography (HRCT), and perfusion and ventilation scintigraphy. One 10-yr-old patient died of severe respiratory insufficiency from alveolar proteinosis. All of the remaining patients were asymptomatic at the time of the study, although HRCT scans revealed signs of lung involvement defined by the presence of acinar nodules, inter- and/or intralobular thickening of the interstitial septa, and subpleural cysts in five of the patients. Radioisotope studies showed an uneven distribution of perfusion and ventilation, and confirmed the presence of segmental and/or diffuse pulmonary functional defects. No abnormalities of pulmonary function were evident, and answers to a questionnaire excluded primary coexisting lung disease. In patients with LPI, including those without clinical and functional impairment, HRCT and radioisotopic studies appear to be the most sensitive methods for the early diagnosis of lung disease and correct assessment of its progression.

Adult↗
PubMed1996

[Diagnostic accuracy and clinical significance of combined small bowel enema and scintigraphy with pure fractions of neutrophil granulocytes labeled with HMPAO-Tc99m in chronic intestinal inflammation].

Enema is the primary imaging method in the diagnosis of Crohn's disease in the small bowel, with clinical follow-up examinations performed by gastroenterologists as the gold standard. The information provided by small bowel enema, in addition to endoscopic findings, is usually sufficient for the gastroenterologist to make the definitive diagnosis and to plan the whole treatment. Scintigraphy with leukocytes labelled with HMPAO-Tc99m has several unique characteristics favoring its use as a diagnostic imaging method in Crohn's disease and ulcerative colitis. It is a noninvasive method requiring no bowel preparation and it is safe in severely ill patients in whom such conventional imaging methods as barium enema or colonscopy might be hazardous. In this study, the authors report the results of their experience with diagnostic small bowel enema and leukocyte scintigraphy with HMPAO-Tc99m in 28 patients with inflammatory bowel disease (Crohn's disease in 18 patients, ulcerative colitis in 7 and radiation-induced inflammatory stenosis of the sigma-rectum, bowel inflammation after appendicectomy and bladder surgery, respectively, in 1 patient each). Scintigraphy with autologous granulocytes with HMPAO-Tc99m was positive in 26 patients and negative in 2. Twenty-five patients were true positives and 1 was a false positive. Fifteen patients were also submitted to small bowel enema: 12 of them were positive (true positive) and 3 negative (1 false negative and 2 true negative). The results of granulocytes scintigraphy were compared with those of small bowel enema: the radionuclide study appeared superior in the assessment of bowel inflammation associated with Crohn's disease and ulcerative colitis. Indeed, scintigraphy depicted granulocyte uptake in the colon where enema had shown no major findings in 4 patients with Crohn's disease. In the author's opinion, the overall sensitivity, specificity and positive predictive value of combined leukocyte scintigraphy and small bowel enema play a major role in the early diagnosis of Crohn's disease and ulcerative colitis and in the assessment of disease extent and activity.

Adolescent↗
PubMed1995

The diagnosis of nonfunctioning pheochromocytoma. The role of I-123 MIBG imaging.

A patient with an asymptomatic nonsecreting left adrenal pheochromocytoma concentrated I-123 MIBG. Iodine-123 MIBG scintigraphy showed abnormal uptake in the left adrenal bed. The authors conclude that I-123 MIBG imaging may allow the in vivo diagnosis of non-functioning pheochromocytomas when there is no clinical evidence of disease and other laboratory measurements are not helpful for tumor diagnosis.

3-Iodobenzylguanidine↗
PubMed1995

Correlative morphologic and functional imaging for diagnosis, staging and follow up in AIDS: an overview.

The immunocompromised patient can be affected by different opportunistic infections and tumors, that can involve all organ systems, and particularly, the central nervous system, the respiratory system, the gastrointestinal tract. The extreme variability of AIDS presentations requires a specific preparation and cooperation between the different diagnostic imaging specialists and a close collaboration with the clinicians. With AIDS, different morphologic and functional imaging techniques can be used for detection of disease sites, assessment of the extent of the disease and monitoring of disease changes over time and response to treatment. The complexity of AIDS presentations is such that full integration of the complementary information obtained with different techniques could be most useful. Image registration (coregistration, fusion) indicates approaches where precise spatial cross-references are obtained, in order to combine the information acquired with different imaging modalities, in particular by blending morphologic CT/MRI data with functional SPET/PET data. In this paper, an overview of the developments in the field of "image fusion" follows some comments on the results of morphologic and functional assessment of brain, chest and abdominal diseases in the course of AIDS, as illustrative examples of the potential benefits of multimodality image correlation.

AIDS-Related Opportunistic Infections↗
PubMed1995

111In-pentetreotide scintigraphy in the post-thyroidectomy follow-up of patients with medullary thyroid carcinoma.

Local and lymphnodal recurrences of medullary thyroid carcinoma (MTC) in thyroidectomy patients with elevated plasma levels of calcitonin and/or CEA can be detected using 111In-pentetreotide (Octreoscan: OCT) scintigraphy, although the sensitivity of this technique in localizing an intrathyroid recurrence of tumor is affected by the low target/non-target uptake ratio. The survival rate of patients with MTC, who have undergone thyroidectomy and who show evidence of a rise in plasma levels of calcitonin and/or CEA is closely linked to the number and localization of the metastases. However the role of conventional imaging techniques (X-rays, US, CT, and MR) in the follow-up after thyroidectomy is controversial. Numerous radiocompounds are currently being used to detect local and distant recurrences of MTC. The present study evaluated OCT and pentavalent 99mTc-dimercapto-succinic-acid (99mTc-DMSA-V) scintigraphy performed in 13 patients with a histologic diagnosis of MTC and in one with MEN 2A, all of whom had undergone thyroidectomy between 3 months and 15 years before. The patients also underwent 123I (NaCI) scintigraphy to evaluate the sites and extension of thyroidal remnants. 111In-pentetreotide scintigraphy was positive in 9/14 patients (64%); the 99mTc-DMSA-V was positive in 5/14 patients (35%). 111In-pentetreotide scintigraphy recognized 18 sites of abnormal uptake (12 in the neck); 9mmTc-DMSA-V detected 9 MTC recurrences in the same patients. In conclusion, 111In-OCT scintigraphy represents, in the authors' experience, a useful method, more sensitive than 9mmTc-DMSA-V, to detect MTC recurrences in patient follow-up post-thyroidectomy.

Adult↗
PubMed1994

Technetium-99m methoxy isobutyl isonitrile simultaneous evaluation of ventricular function and myocardial perfusion in patients with congenital heart disease.

The authors evaluated the clinical applications of Tc-99m methoxy isobutyl isonitrile (MIBI) in the simultaneous assessment of ventricular function and myocardial perfusion in patients with congenital heart disease. Global ventricular function was assessed by first-pass ECG gated study. Myocardial perfusion was evaluated on images performed 1 hour after the injection of the tracer. Regional wall motion and systolic thickening were assessed by gated study acquired after the perfusion study. Two young patients were studied after a surgical Glenn procedure. The first patient, with a history of transposition of the great vessels and univentricular heart, had an ejection fraction of 44%. The left ventricle was dilated and the right ventricle was not appreciable. The septal and inferoapical regions showed reduced perfusion and reduced systolic thickening. The second patient, with a history of pulmonary atresia, septal defect and left ventricular hypoplasia, had a right ventricular ejection fraction of 37%. Regional wall motion, systolic thickening, and myocardial perfusion were normal. The right ventricle was hypertrophic and larger than the left ventricle. Thus, a single injection of Tc-99m MIBI allows noninvasive simultaneous assessment of global and regional ventricular function and myocardial perfusion in young patients with complicated congenital heart disease.

Child, Preschool↗
PubMed1994

[Scintigraphy with gallium-67 citrate in patients with AIDS: pathologic extrapulmonary uptake].

67Gallium citrate can accumulate in different inflammatory and neoplastic lesions. The mechanisms of 67Gallium uptake in abnormal tissue are still partially unknown and the tracer is considered a nonspecific indicator of disease. In AIDS patients, 67Gallium citrate is used in the diagnosis and characterization of opportunistic pulmonary infections and especially of Pneumocystis carinii pneumonia. From June 1989 through December 1992 in our Department 140 67Gallium scans were performed on 103 AIDS patients, referred for evaluation of pulmonary symptoms. All studies were carried out 72 hours after i.v. administration of 185 MBq 67Gallium citrate, with anterior and posterior views of head, chest and abdomen. The images were evaluated with conventional diagnostic criteria and site, number and intensity of abnormal foci of extrapulmonary uptake were recorded. Abnormal extrapulmonary uptake was found in 17 patients (12%): gastric (3, two of which also exhibited abnormal intestinal uptake), esophageal (1) hepatic (1), intestinal (2) renal (4), nodal (3), ocular (1), cutaneous (1), sinusal (1) localizations. In all cases clinical, endoscopic, bioptic or microbiological demonstration of the possible cause of 67Gallium uptake was obtained. An intriguing finding in our series was the lower incidence of gastric uptake (two patients with miliary tuberculosis and one patient with gastric candidiasis) than in the literature. This finding could be explained by clinical and epidemiologic differences between different patient populations. However, the scan interval after tracer administration should be also taken into account, since in our study scans were always performed at 72 hours, while in other series the interval ranged 24-48 hours. The relatively high incidence of abnormal extrapulmonary uptake confirms the opportunity of whole body exploration after 67Gallium administration in the patients with such multisystemic disease as AIDS, even when the patients are referred mainly for respiratory problems.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Non-Hodgkin's lymphoma in a patient with follicular thyroid cancer: the role of 99mTc-methoxy isobutyl isonitrile imaging.

In the post-surgical follow-up of a patient with follicular thyroid carcinoma, a palpable mass in the left supraclavicular region was highly indicative of metastatic disease. Technetium-99m methoxy isobutyl isonitrile (99mTc-MIBI) showed an increased but heterogeneous uptake within the lesion. Surprisingly, a different neoplastic disease was histologically demonstrated. Lymph node abnormalities due to non-Hodgkin's lymphoma rather than metastatic thyroid disease were demonstrated. In conclusion, non-Hodgkin's lymphoma may occur in patients with follicular thyroid carcinoma. This new lesion significantly concentrated 99mTc-MIBI. Thus, the results of 99mTc-MIBI imaging have to be carefully evaluated during the follow-up of patients with thyroid cancer.

Adenocarcinoma, Follicular↗
PubMed1993

[Lung interstitial disease in systemic sclerosis: semiologic characteristics with high-resolution computerized tomography and comparison with other methods].

In 28 patients with systemic sclerosis interstitial lung involvement was investigated with high-resolution Computed Tomography (HRCT) in comparison with other diagnostic methods (respiratory function tests, lung scintigraphy and conventional radiography of the chest). The most frequent CT signs were: interlobular septal thickening, intralobular interstitial thickening, and ground-glass density. Their distribution was generally basal and posterior and high correlation was observed between the extent of lung disease and the cutaneous pattern of scleroderma. Pathological findings were present in 93% of cases: HRCT can must be considered more effective than the other methods in the evaluation of systemic sclerosis and should therefore be a fundamental diagnostic tool in the study and follow-up of interstitial diseases in the patients with systemic sclerosis.

Adult↗
PubMed1992

Comparison between exercise and trans-oesophageal atrial pacing in patients with coronary artery disease: technetium-99m methoxy isobutyl isonitrile simultaneous evaluation of ventricular function and myocardial perfusion.

In this study we compared the results of exercise and trans-oesophageal atrial pacing (TAP) technetium-99m methoxyisobutyl isonitrile (99mTc-SESTAMIBI) cardiac imaging in the evaluation of left ventricular (LV) function and myocardial perfusion in patients with angiographically proven coronary artery disease. Ten patients (8 men and 2 women, mean age 59 +/- 6 years) were submitted to 3 separate injections of 99mTc-SESTAMIBI, one under control conditions, one after exercise and one after TAP. LV ejection fraction, as measured by electrocardiogram (ECG) gated first pass, decreased from 49 +/- 5% under control conditions to 42 +/- 6% during exercise (P less than 0.05 versus control) and to 43 +/- 8% during TAP (P less than 0.05 versus control and insignificant change versus exercise). Segmental myocardial perfusion analysis was performed on a total of 150 myocardial segments. On both exercise and TAP 99mTc-SESTAMIBI studies, 103 segments (69% of the total) were normal, 32 (21%) had reversible, and 15 (10%) irreversible, perfusion defects. Relative regional tracer uptake was not statistically different between exercise and TAP in normal regions (91.1 +/- 9.1% versus 90.7 +/- 8.5%, respectively), in regions with reversible (61.9 +/- 12% versus 62.4 +/- 10.4%, respectively) and irreversible perfusion defects (55.8 +/- 7.8% versus 58.8 +/- 9.5%, respectively). Our results demonstrated that 99mTc-SESTAMIBI TAP cardiac imaging shows similar results to 99mTc-SESTAMIBI exercise myocardial scintigraphy in the assessment of LV function and myocardial perfusion in patients with coronary artery disease.

Cardiac Pacing, Artificial↗