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Biomedical subjects

L Galli

Publications and source records attributed to L Galli.

At least 19 recordsLinked to original sources
PubMed1992

Presurgical identification of hibernating myocardium by combined use of technetium-99m hexakis 2-methoxyisobutylisonitrile single photon emission tomography and fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography in patients with coronary artery disease.

We tested the possibility of identifying areas of hibernating myocardium by the combined assessment of perfusion and metabolism using single photon emission tomography (SPET) with technetium-99m hexakis 2-methoxyisobutylisonitrile (99mTc-MIBI) and positron emission tomography (PET) with fluorine-18 fluoro-2-deoxy-D-glucose (18F-FDG). Segmental wall motion, perfusion and 18F-FDG uptake were scored in 5 segments in 14 patients with coronary artery disease (CAD), for a total number of 70 segments. Each subject underwent the following studies prior to and following coronary artery bypass grafting (CABG): first-pass radionuclide angiography, electrocardiography gated planar perfusion scintigraphy and SPET perfusion scintigraphy with 99mTc-MIBI and, after 16 h fasting, 18F-FDG/PET metabolic scintigraphy. Wall motion impairment was either decreased or completely reversed by CABG in 95% of the asynergic segments which exhibited 18F-FDG uptake, whereas it was unmodified in 80% of the asynergic segments with no 18F-FDG uptake. A stepwise multiple logistic analysis was carried out on the asynergic segments to estimate the postoperative probability of wall motion improvement on the basis of the preoperative regional perfusion and metabolic scores. The segments with the highest probability (96%) of functional recovery from preoperative asynergy after revascularization were those with a marked 18F-FDG uptake prior to CABG. High probabilities of functional recovery were also estimated for the segments presenting with moderate and low 18F-FDG uptake (92% and 79%, respectively). A low probability of functional recovery (13%) was estimated in the segments with no 18F-FDG uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Artery Bypass↗
PubMed1992

Transrectal microwave hyperthermia for benign prostatic hyperplasia: long-term clinical, pathological and ultrastructural patterns.

Transrectal microwave hyperthermia of the prostate was administered to 191 patients with bladder outlet obstruction due to benign prostatic hyperplasia who were either at poor operative risk or who refused surgery. Patients were divided in 2 groups according to age and they underwent either 5 or 10, 60-minute sessions of hyperthermia, with a calculated intraprostatic temperature of 42.5 plus or minus 0.5C. Light and electron microscopy showed no irreversible damage at the glandular epithelium but did demonstrate a significant increase in neoformed intraprostatic capillary-like vessels. At 1, 12 and 24 months residual urine volume was significantly decreased in the majority of patients but only a minor amelioration of urinary flow rates and subjective symptoms was observed. According to maximum flow nomograms all patients were still obstructed postoperatively. Transrectal hyperthermia cannot be considered a genuine alternative to surgery for patients with bladder outlet obstruction due to benign prostatic hyperplasia.

Aged↗
PubMed1992

Transrectal microwave hyperthermia for advanced prostate cancer: long-term clinical results.

Transrectal microwave hyperthermia was applied to 46 stages D1 and D2 prostate cancer patients to treat urinary symptoms and local pain unrelieved by total androgen ablation therapy. Hyperthermia was administered in 10, 60-minute sessions twice a week for 5 weeks. A calculated intraprostatic temperature of 43.5 +/- 0.5C was maintained throughout the treatment. At 2 years the mean residual urine volume was significantly decreased (p less than 0.05), while the mean peak flow rate and maximum flow nomogram were improved but not significantly. The majority of patients reported a notable amelioration of subjective symptoms and quality of life. The only complication was a prostatorectal fistula that was cured by leaving a urethral catheter in place for 4 weeks. Prostatic hyperthermia is a safe and effective palliative procedure for bladder outlet obstruction due to advanced prostate cancer.

Aged↗
PubMed1992

Transrectal hyperthermia-induced histological and ultrastructural changes of human benign prostatic hyperplasia tissue.

This prospective study evaluated the tissutal, cellular and intracellular effects of transrectal microwave hyperthermia on human benign prostatic hyperplasia. Forty-eight patients with benign prostatic hyperplasia underwent ten 60-min-long sessions of transrectal hyperthermia with an intraprostatic calculated temperature of 42 +/- 0.5 degrees C. Ultrasound-guided transperineal biopsies of the prostate were taken before and 1 month after completion of treatment. Postoperatively, morphometric analysis of bioptic specimens showed a statistically significant (p < 0.01) increase in the number of intraprostatic arterioles and capillary-like vessels. Diffused inflammatory infiltrates were also noted. Postoperative integrity of intracellular organelles and cellular membranes was evidenced by transmission electron microscopy. Our regimen of transrectal prostatic hyperthermia did not cause any irreversible histological or ultrastructural damage to the prostatic tissue. Hyperthermia-induced increase in blood flow could enhance drug delivery to the prostate gland.

Humans↗
PubMed1992

[Long-term results of treatment of benign prostatic hypertrophy by trans-rectal prostatic hyperthermia].

From November 1987, 250 patients with symptomatic benign prostatic hyperplasia underwent transrectal prostatic hyperthermia. Forty-six patients had an indwelling catheter while 204 patients were obstructed but could still void spontaneously. Hyperthermia was administered in 5 or 10 sixty-minute sessions, with a calculated intraprostatic temperature of 42.5 or 43 degrees C. At the two-year follow-up, residual urine volume was significantly decreased while peak flow rate, maximum flow nomogram and subjective symptoms were only slightly improved, i.e. patients were still obstructed postoperatively. Transrectal prostatic hyperthermia cannot be considered as a first choice therapy for symptomatic benign hyperplasia but it can be offered only to carefully selected patients who cannot undergo any alternative therapeutic procedure.

Aged↗
PubMed1992

HIV-1 transmission through breast-milk: appraisal of risk according to duration of feeding.

OBJECTIVES: To estimate the risk of HIV-1 transmission through breast-milk in children born to infected mothers, and to determine the relationship between duration of breast-feeding and risk. DESIGN AND METHODS: The study population included 168 breast-fed and 793 bottle-fed children born to seropositive mothers. All subjects were enrolled and followed-up in the Italian Register for HIV Infection in Children; HIV sero-status was defined in all children. Multivariate analysis was performed using a logistic regression model. Independent variables included biological factors (duration of breast-feeding, gestational age, clinical condition of mother at delivery, mode of delivery, birth-weight and sex). Year of birth and age when HIV infection was diagnosed were also considered in the analysis attempting to control for possible selection biases. RESULTS: Breast-feeding increased the risk of HIV-1 transmission. The estimated adjusted odds ratio for 1 day of breast- versus bottle-feeding was 1.19 (95% confidence interval, 1.10-1.28). The infection odds ratio of breast- versus bottle-feeding increased with the natural logarithm of the duration of practice. CONCLUSIONS: These results are the first to provide an appraisal of the additional risk of HIV-1 transmission associated with a seropositive mother breast-feeding her child. Biological significance of this route of transmission was supported by demonstration of a relationship between duration of breast-feeding and risk of HIV-1 transmission.

Breast Feeding↗
PubMed1992

[Nutrients, anthropometric characteristics and osteoporosis in women in the recent and late postmenopausal period].

Bone mineral content (BMC) at two different radial sites (mid-diaphysis and ultra-distal epiphysis), anthropometric measurements (Body Mass Index, Lipidic Area, and Muscular Area) and nutrients intake were measured in two populations of women selected on the basis of early (< 9 years) or remote (> 15 years) menopause. The results show the presence of positive relationships between BMC, and protein and lipid intakes in the population of women in early menopause; in the other population no relationships were found. Glucid, fibre and calcium intakes were not related to the BMC of both populations. The positive relationships between BMC, and protein and lipid intakes in the population of women in early menopause is likely mediated by anthropometric characteristics as Body Mass Index and Muscular Area.

Adult↗
PubMed1992

[Dual-energy X-ray absorptiometry of the vertebrae: determining which vertebrae should be scanned].

This study was aimed at verifying whether bone mineral density (BMD) and its loss with aging are different in the lumbar vertebrae and whether the region of interest--which is usually limited to the L2-L4 segment--may be extended to L1-L4. BMD was measured by means of dual-energy X-ray absorptiometry (Hologic QDR 1000) in 74 women, aged 37 to 78 years, not affected with any disease or subjected to any treatment known to interfere with bone metabolism. The relationship between age and BMD was expressed by the following equations for L1, L2, L3: BMD-L1 = 1181.68-7.85 x age, BDM-L2 = 1251.57-7.70 x age, BMD-L3 = 1231.66-6.57 x age, as shown by linear regression analysis. The behavior of the bone density of L4 with age appeared to be different and could not be described by linear regression curves and was therefore not comparable with that of the other vertebrae. BMD was different in the four lumbar vertebrae as shown by: a) the diversity of the intercept of the regression lines describing age-bone density relationships (F = 7.7, p < 0.001); b) the bone density of L1 being lower than the mean bone density of the L2-L4 region (p < 0.005); c) the bone density of L4 being higher than the mean bone density of the L1-L3 region (p < 0.001). In order to evaluate the effect of senile degenerative changes of the vertebrae on the relevant bone density, two groups of women were considered, according to age--i.e., pre- or iuxtamenopausal and late postmenopausal. It appeared that the BMD of L1 was always more correlated to the bone density of L2 and L3 than the BMD of L4. Our results suggest that L1 is homogeneous to the L2-L3 region, relative to both bone density and its loss with aging. Therefore, L1 should be included in the region of interest during the examination. Even though the bone mineral content of L4 and its loss with aging seem to be different, our results do not allow the exclusion of L4 from the scanned area.

Absorptiometry, Photon↗
PubMed1992

Mother-to-child transmission of human immunodeficiency virus type 1: risk of infection and correlates of transmission.

One thousand eight hundred eighty-seven children born to human immunodeficiency virus type 1 (HIV-1) seropositive mothers, including 1045 infants prospectively followed up from birth, were studied. Intravenous drug use was the most frequent maternal risk factor, although the percentage of women infected by sexual contact increased from 5.8% in 1985 to 28.5% in 1990. Of the 551 first children followed up from birth and older than 15 months of age, 101 (18.3%) acquired infection and seroconverted to HIV-1. Another 31 (5.6%) asymptomatic seronegative children showed the presence of viral markers, for an apparent mother-to-offspring transmission rate of 23.9%. Overlapping results were seen in 22 second-born children followed up from birth. Of 59 sibships with definite infection status, when the first child was infected, 14 (40%) of 35 second children were infected, whereas when the first child was not infected, only 2 of 24 (8.3%) second children were infected. Discordance in HIV-1 transmission was found in 1 of 18 pairs of twins. Univariate and multivariate analyses of possible risk factors for HIV-1 transmission performed on the entire population of children and in the cohort of those followed up from birth were basically in agreement in indicating that the development of symptoms in the mother before delivery and breast-feeding (indeed adopted in only 22 infants in whom HIV-1 infection was identified at birth) were significantly and independently associated with a higher transmission rate. In addition, girls were more frequently infected than boys.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Feeding↗
PubMed1991

Adrenal incidentalomas: what is the role of fine needle biopsy?

A series of 13 patients with incidental adrenal mass discovered by computed tomography or/and ultrasound is reported. In 5 cases endocrine evaluation and radiological criteria suggested the diagnosis of the mass. In 8 cases we carried out fine needle biopsy (FNB) under ultrasound guidance. FNB confirmed in two cases the presence of metastatic diseases, in one case adrenal adenoma, in other two cases myelolipoma and in one case lymphoma. Surgical exploration was avoided in all cases. In two cases the presence of an asymptomatic adrenal carcinoma and of a giant adenoma, potentially malignant, was demonstrated by FNB. None of the patients underwent surgical exploration as a final diagnostic measure. In conclusion, FNB may represent a useful tool to select the best modalities of treatment.

Adenoma↗
PubMed1991

Prognostic significance of immunologic changes in 675 infants perinatally exposed to human immunodeficiency virus. The Italian Register for Human Immunodeficiency Virus Infection in Children.

Neutrophil, lymphocyte, and T-cell subset numbers and immunoglobulin levels were evaluated at birth to age 2 years in 675 children born to mothers infected with the human immunodeficiency virus type 1 (58 infected symptom-free subjects (P-1), 203 infected subjects with symptoms (P-2), and 414 uninfected subjects). The P-2 patients had (even at birth to age 1 month) lower CD4+ lymphocyte and higher IgA and IgM values than P-1 and uninfected children had. Increased IgG values (from 1 to 6 months of age) and increased CD8+ lymphocyte numbers (at 13 to 24 months of age) were also observed. The P-1 children differed from uninfected children only at 13 to 24 months of age (decreased CD4+ and increased CD8+ lymphocytes). Progressive immunologic changes were found in P-2 patients who had severe clinical conditions and in those who died. To evaluate the predictive meaning of the immunologic changes, we selected 164 children (25 P-2, 15 P-1, and 124 uninfected children) because they had been examined sequentially from birth and they were classified as in the indeterminate state of infection (P-0) at immunologic evaluations at birth to age 1 and at 1 to 6 months of age. During the 1- to 6-month period, P-2 patients had higher immunoglobulin and lower CD4+ lymphocyte values than P-1 and uninfected children had; no difference was found between P-1 and uninfected subjects. These results indicate that in infants with perinatal human immunodeficiency virus type 1 infection, immunologic abnormalities correlate with the clinical condition and are predictive of the clinical outcome rather than the infection status.

CD4-Positive T-Lymphocytes↗
PubMed1991

The neodymium:YAG laser recanalization in a patient with azoospermia due to ejaculatory duct agenesis.

A 32-year-old man with azoospermia is presented. Transperineal echographically guided vesiculography of the vas deferens showed absence of the ejaculatory duct and presence of a cystic müllerian duct in which both enlarged seminal vesicles joined. Transurethrally, by means of a contact tip over the verumontanum a new channel was created by neodymium:YAG laser irradiation at 25 watts every 2 seconds. The patient had 32.10(6) spermatozoa per ml. with good quality on semen analysis 10 months later.

Adult↗
PubMed1991

Decreased platelet serotonin uptake in bipolar I patients.

The 5HT transporter complex in platelets is similar to that in the brain and thus widely used in biological psychiatry as a peripheral marker of the 5HT system. Our study aim was to measure 14C-5HT uptake parameters (Vmax and Km) in platelets from 12 patients affected by bipolar disorder, as compared with 12 healthy controls. The uptake assay was performed according to the method of Arora and Meltzer (1981). The results showed that the Vmax was significantly lower in bipolar patients than in healthy controls, with no modification of the Km. These preliminary data would indicate therefore that the mechanism of 5HT transport is altered in platelets of bipolar patients.

Adult↗
PubMed1991

HIV-I infection in perinatally exposed siblings and twins. The Italian Register for HIV Infection in Children.

In a multicentre study on perinatal HIV-I infection including 1493 children born from 1471 pregnancies to 1415 infected mothers, 22 twin pairs and 56 sibships (115 children) were recorded. The frequency of twin pregnancies was 1.5 (22/1471) and 3.9% (56/1415) seropositive women had more than one at risk pregnancy. In 18 twin pairs with a known infection status nine of the 36 children (25%) were infected. Discordance in infection status was present in only one (5.5%) dizygous pair. A high relative risk of infection (23.1) in a twin was observed when the other was infected. Infection was unrelated to gestational age, mode of delivery, or birth weight. Infection status was defined in 41 sibships (84 children including one first born twin pair and one third born child). When the first born was infected, 11/26 (42.3%) second born children were also infected, whereas this happened in only 2/16 (12.5%) second or third born children when the first born was uninfected. Two out of nine first born (22.2%) and 5/21 (23.8%) second born children prospectively followed up from birth acquired the infection. Results of this study demonstrate that neither twin nor second pregnancies are at increased risk of mother to child HIV-I transmission. Overall data suggest that non-casual factors in mother and/or child influence perinatal infection.

Diseases in Twins↗
PubMed1991

[Intraprostatic prosthesis: echographic monitoring].

22 patients affected by BPH have been treated with a spiral urethral prosthesis under local anesthesia with ultrasonic guidance and endoscopic technique. All the patients either refused the surgical procedure or had high operative risk. Insertion guided by ultrasound and endoscopic technique was successful in 19 patients (86%) with a follow-up of 12 months. In our experience the insertion of this prosthesis is a favorable alternative to an indwelling catheter in selected patients.

Aged↗
PubMed1991

[Transrectal echography in the diagnosis of non-palpable prostatic carcinoma].

285 affected by BPH have been evaluated by transrectal ultrasound. All the patients had a palpably normal prostate without abnormality suggestive of cancer. 56 patients (19.6%) presented ultrasonic abnormality areas. Under ultrasound guidance, biopsy was done by the transperineal route and biopsy material showed the presence of prostatic carcinoma in 24 patients (8.3%). 6 of these had neoplasm in the non peripheral zone. The study suggests the validity of ultrasound, in particularly transrectal ultrasound, in the identification of non palpable prostatic cancer. In conclusion ultrasound appears very useful in the preoperative evaluation of the patients affected by BPH in order to identify neoplasms non detectable with other methods.

Adenocarcinoma↗