PubMed HealthSearch

Biomedical subjects

L Gianolli

Publications and source records attributed to L Gianolli.

8 recordsLinked to original sources

99mTc-2GAM: a tracer for renal imaging.

We propose a renal imaging agent, the 99mTc complex of the bidentate-N,S chelate N-(mercaptoacetyl)glycine (99mTc-2GAM), with the imaging characteristics of 99mTc-DMSA but a faster kidney uptake; chemical evidence supports the formulation of 99mTc-2GAM as [Tc(v)(O)(GAM)2]-. After biodistribution and toxicity studies in animals, 99mTc-2GAM was evaluated in five normal volunteers. 99mTc-2GAM is rapidly cleared from the blood (t1/2 = 9 min) and 50% of the ID is excreted in the urine in the first 2 h. Dynamic data show a rapid renal uptake that increases up to 1 h with no significant wash-out between 1 and 8 h. The uptake in each kidney ranges from 11.3% to 20.7% ID. Low, stable liver uptake is observed. No significant activity is detected in other organs. We showed no differences between 99mTc-2GAM and 99mTc-DMSA compared in three patients with unilateral kidney disease. We conclude that 99mTc-2GAM has good practical and dosimetric features for renal imaging.

Adult

High prevalence of the thallium-201 reverse redistribution phenomenon in patients with syndrome X.

OBJECTIVE: To evaluate the stress-myocardial perfusion pattern in patients with angina, positive exercise test and angiographically smooth coronary arteries (syndrome X). DESIGN: Prospective study. PATIENTS AND METHODS: Twenty-five consecutive patients (seven males, mean age 54 +/- 8 years) with typical angina, positive exercise test, normal coronary arteries and no inducible spasm, underwent stress-redistribution thallium-201 myocardial perfusion scintigraphy. Thirty-two consecutive patients (14 males, mean age 49 +/- 7 years) with atypical chest pain and negative exercise test, undergoing stress-redistribution thallium scan, served as controls. RESULTS: Exercise was discontinued for angina and/or ST-segment depression after 12 +/- 3 min. Thallium stress images revealed 40 hypoperfused segments in 27 patients (77%); after 4 h, 16 of these segments had completely normalized, 10 remained unchanged, six exhibited partial reperfusion and eight worsened. Twenty-four patients (69%) exhibited thallium reverse redistribution in 33 segments. Thirty-four patients (97%) had at least one hypoperfused segment in one of the two scintigraphic phases. Of the 24 patients with reverse redistribution, eight also underwent stress-rest 99m Tc-MIBI SPECT: six exhibited reduced tracer uptake that was present at rest, but not on stress images, in the same segments showing thallium reverse redistribution. Thallium stress images revealed four hypoperfused segments in three controls (9%); at redistribution, one segment normalized, two remained unchanged and one exhibited partial reperfusion. Additionally, there were four new underperfused segments appearing on redistribution in four patients (13%). Overall, there were seven controls (22%) with at least one hypoperfused myocardial segment in one of the two scintigraphic phases. CONCLUSIONS: Our study confirms that perfusion abnormalities are present in most syndrome X patients. Additionally, the data show that reverse redistribution (a perfusion defect that develops or becomes more evident on delayed imaging) is a common finding in these patients. The mechanisms of the phenomenon remain obscure: we suggest that it is due to inhomogeneous perfusion, and the hyperaemic response induced by exercise masks resting underperfusion of certain areas.

Adult

Reverse perfusion pattern of Tc-99m MIBI heralding the development of myocardial infarction.

In a patient with sporadic atypical chest pain associated with dyspnea, stress Tc-99m MIBI imaging showed normal perfusion and inferoposterior hypoperfusion on the resting study. Although this reverse perfusion pattern was considered artifactual, the patient later had an acute myocardial infarction involving the same areas. Postinfarction stress Tc-99m MIBI imaging showed a nonreversible defect in the same area that, in the earlier study, showed a reverse perfusion pattern. The authors hypothesize that partial stenosis of the related artery with some nontransmural myocardial necrosis at the time of the initial study may be a possible cause of this peculiar Tc-99m MIBI perfusion pattern.

Aged

Ectopic thyroid tissue in the ventricular outflow tract: embryologic implications.

The case of a 66-year-old female patient with a tumor located in the right ventricular outflow tract is reported. Histologic examination of an intraoperative biopsy revealed that the tumor was an intracardiac ectopic thyroid. We performed conservative surgery with partial resection of the mass. After 5 years, the patient is asymptomatic and leading a normal life. The authors examine the relation between the embryologic development of the primitive heart and the thyroid primordium and suggest the hypothesis of ectopic thyroid location in the right- or left-ventricular outflow tract.

Aged

Decrease of glomerular hyperfiltration in short-term diabetic adolescents without microalbuminuria.

OBJECTIVE: This study has been designed to follow prospectively the GFR and UAE of young patients with short-term IDDM and normal UAE. RESEARCH DESIGN AND METHODS: The study population consisted of 19 patients with glomerular hyperfiltration and 19 patients with normal GFR, matched for duration of diabetes and age. GFR has been assessed by radioisotopic tracer and UAE by RIA at the beginning of the study and after 30.5 +/- 10.4 mo of follow-up. RESULTS: GFR decreased in the two groups btt delta GFR of patients with glomerular hyperfiltration was greater than delta GFR of patients with normal GFR (0.83 +/- 0.55 vs. 0.28 +/- 0.63 ml.min-1.mo-1; P < 0.01). UAE, BP, and prevalence of microalbuminuria were comparable between the two groups at follow-up. Rate of fall of GFR was positively correlated with initial GFR (r = 0.59, P < 0.001) but not with initial UAE, BP, or changes in HbA1C, UAE, BP, or pubertal development during follow-up. CONCLUSIONS: Investigation of kidney function in children and adolescents with IDDM over a 3-yr follow-up period shows that glomerular hyperfiltration is characterized by a greater decline in GFR without an increased rate of appearance of microalbuminuria, than in patients with normal GFR.

Adolescent

High-pressure hemarthrosis: possible consequences to the vascularization of the femoral head.

The authors both detected hemarthrosis and calculated intraarticular pressure and blood supply to the femoral head using diagnostic tests (ultrasound, arthrography, manometric measurements, and bone scan tomography) in 18 patients with femoral neck fracture. The data obtained, in agreement with other reports in the literature, show a relationship between the condition of the joint capsule, the level of intraarticular pressure, and the arterial blood supply to the femoral head in cases of undisplaced or slightly displaced femoral neck fracture. The potential clinical implications are discussed.

Aged

[Possible correlations between protein-loosing nephropathy and obesity].

Nephrotic syndrome has been reported in obesity; its precise incidence in obese patients without diabetes mellitus and/or arterial hypertension is however unknown. Thirty-two obese subjects without complications were therefore assessed before and after weight loss, together with 18 healthy control subjects. Overnight albumin excretion rate (AER) was assessed using a RIA method (H. Albumin-Kit, Sclavo). Glomerular filtration rate (GFR) was also evaluated in 10 obese subjects using Cr51 before and after weight loss. AER was found to be higher, although the difference was not statistically significant, in obese subjects compared to controls, but was significantly reduced after weight loss (p = 0.05). GFR also showed a non-significant tendency to decrease following loss of weight. Systolic and diastolic blood pressures were significantly decreased following weight loss (p less than 0.01 and p less than 0.025 respectively). In conclusion, although it is not possible to confirm the presence of true nephropathy in uncomplicated obesity, the latter can facilitate the onset of hemodynamic-type mechanisms which, in the presence of diabetes mellitus or arterial hypertension, may lead to the appearance of the nephrotic syndrome.

Adolescent