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Biomedical subjects

L Guariglia

Publications and source records attributed to L Guariglia.

At least 37 records · Page 2Linked to original sources

[Embryo-fetal ultrasonographic diagnosis in the early pregnancy using transvaginal echography].

The diagnostic capability of high resolution transvaginal sonography in early pregnancy is described. Transvaginal sonography allows for the visualisation of some fetal organs and structures one to four weeks earlier than transabdominal ultrasound thus permitting evaluation of several embryofetal parameters early in pregnancy. This technique permits formulation of fetal measurement charts and detection of embryo-fetal malformations during the initial stages of pregnancy. Knowledge of the transvaginal sonographic appearance of embryonal and fetal biometric and structural anatomy enables us to determine the appearance of the normal fetus. Transvaginal scan may be employed as a screening tool for the identification of fetal anomalies in early stages of pregnancy. An increasing number of case reports and documented records of cases of malformations and anomalies diagnosed during the first trimester of pregnancy using this technique have been reported in the literature. The most frequent embryo-fetal malformations and anomalies detected at transvaginal scan and the earliest gestational age of diagnosis are described. At present a limited number of anomalies can be diagnosed because only a part of the potentially recognizable anomalies have been described using this technique. The importance of this new imaging technique as well as the necessity of a through knowledge of embryology are evident. Transvaginal sonography allows for biometric evaluation, for a clearer visualization of embryo-fetal morphology and for detection of several malformations and anomalies during early pregnancy.

Congenital Abnormalities↗

Fetal biometric ratios by transvaginal sonography as a marker for aneuploidies in early pregnancy.

The aim of this study was to obtain by transvaginal sonography in early pregnancy normal biometric charts of some fetal ratios and to evaluate the utility of these ultrasonographic indices as biometric markers for the identification of fetal chromosome abnormalities. The study population included 1054 normal euploid fetuses and 30 fetuses with an abnormal karyotype. We obtained six standard ultrasound measurements by transvaginal sonography at 11-16 weeks' gestation before genetic amniocentesis in patients at risk for genetic disorders. Seven biometric ratios (biparietal diameter/femur length, biparietal diameter/humerus length, head circumference/abdominal circumference, abdominal circumference/femur length, abdominal circumference/humerus length, femur length/foot length, and humerus length/foot length) were calculated and reference curves were plotted. The ratios from aneuploid fetuses showed no differences from reference ranges. Only in trisomy 13 fetuses were abnormal values of head circumference/abdominal circumference, biparietal diameter/humerus length, and biparietal diameter/femur length ratios detected, probably due to the high incidence of microcephaly and central nervous system malformations in these fetuses. The normal values of sonographic ratios obtained by transvaginal sonography in the first and early second trimester of pregnancy cannot generally be considered a useful tool for the detection of chromosomal abnormalities. Only ratios involving cephalic measurements can be used in early pregnancy as screening markers in the detection of trisomy 13 fetuses.

Aneuploidy↗

[Early diagnosis of embryo-fetal malformations by transvaginal echography in a high-risk population].

BACKGROUND: High resolution transvaginal sonography permits, in respect of traditional transabdominal scan, an earlier diagnosis of some fetal anomalies and malformations. METHODS: In our prospective study, between 11th to 16th weeks gestation, 820 pregnant patients at high risk for chromosomopathies and for fetal malformations were scanned in order to obtain a detailed survey of embryofetal structures and organs and an earlier diagnosis of fetal malformations. RESULTS: Thirty-two fetal anomalies and malformations (3.9%) were detected, and in 4 cases (0.49%) the diagnosis was obtained later in pregnancy. Fetuses with structural malformations were scanned during pregnancy and, if possible, postnatally. We reconsidered the pitfalls in relation to the time of transvaginal scan and the fetal pathology. CONCLUSIONS: En early prenatal diagnosis of fetal anomalies by transvaginal sonography is related to the knowledge of normal embryofetal development and the pathogenesis of malformations.

Adult↗

[Embryo-fetal development in the early stages of pregnancy].

The introduction of high resolution transvaginal US in obstetrical clinical practice permits earlier and more detailed visualization of embryo-fetal structures in early pregnancy. A transvaginal US examination with a high-resolution probe (5.0-6.0 MHz) was performed in 1246 pregnant patients between 9 and 16 weeks of gestation and known gestational age. Ten embryo-fetal biometric parameters were measured (crown-rump length, biparietal diameter, head circumference, transverse cerebellar diameter, thoracic circumference, mean abdominal diameter, abdominal circumference, femur length, humerus length and foot length). Reference ranges with 5 degrees and 95 degrees percentile intervals were constructed for all biometric parameters in relation to gestational age. Only one scan per patient was considered for this study. All the parameters evaluated demonstrated a high correlation with gestational age at polynomial regression analysis. The mean coefficient of determination (r2) ranged from 97.15 for biparietal diameter to 88.17 for transverse cerebellar diameter. The data are useful as reference range for the assessment of normal embryofetal development by transvaginal US in the early stages of pregnancy.

Embryonic and Fetal Development↗

[Echographic markers of fetal chromosomopathies. Diagnostic possibilities with transvaginal ultrasonography and our experience].

OBJECTIVE: Aim of this study was to evaluate, during early pregnancy, the correlation of some anomalies and malformations with fetal chromosomopathies. EXPERIMENTAL DESIGN: Morphostructural and biometric anomalies in chromosomopathic fetuses were evaluated. PATIENTS: 1331 pregnancies at high risk for genetic disease and malformations referred to our center for prenatal diagnosis. METHOD: Scans were performed using endovaginal convex probes (5.0 to 7.0 MHz). SURVEYS: Urinary, cardiac and cerebral malformations as well as alterations of bone growth were evaluated. RESULTS: With respect to the other malformations, cystic hygroma is more frequently associated with an abnormal fetal karyotype. CONCLUSIONS: The majority of morphostructural abnormalities diagnosed during first trimester by transvaginal sonography cannot, in according to personal experience, be used as markers of chromosomopathies.

Chromosome Aberrations↗

[Early prognostic ultrasonographic indices in pregnancy with fetal cystic hygroma].

OBJECTIVE: Aim of this study was the correlation of same early ultrasonographic signs with fetal karyotype, prognosis of pregnancy and neonatal outcome. EXPERIMENTAL DESIGN: Volume of cystic hygroma and presence of septations are correlated with fetal karyotype and an ultrasonographic follow-up was carried out during pregnancy. Details concerning neonatal outcome were recorded at delivery. PATIENTS: Diagnosis was performed in 13 patients between 8.3 to 16.5 weeks' gestation referred to our center for prenatal diagnosis or for obstetric reasons. METHOD: Ultrasonographic examinations were performed using 5.0 and 6.0 MHz endovaginal convex probes. SURVEYS: Hygroma was diagnosed as a cystic dilatation in the nuchal region larger than 3 mm in diameter in the anterolateral aspects. The volume was calculated considering the lesion as spherical and using the standard formula for an ellipsoid volume; the presence of septations was considered. RESULTS: A volume greater than 70 cc3 and the presence of septations demonstrated a strictly correlation with fetal karyotype, evolution of the features, pregnancy and neonatal outcome. CONCLUSIONS: Prognosis varies depending on fetal karyotype, volume, presence of septations and other associated malformations. The volume of the hygroma and the presence of septa are associated with higher incidence of chromosomal diseases and a poorer fetal prognosis.

Female↗

Transvaginal sonographic assessment of the fetal urinary tract in early pregnancy.

Fetal renal size in the first trimester and the early second trimester of pregnancy was evaluated by high-frequency transvaginal sonography in 537 singleton fetuses at risk for cytogenetic abnormality but not at risk for congenital kidney disease. The percentage of visualization of both kidneys and bladder at different menstrual ages (11-16 weeks) is presented, and centile reference charts for evaluating kidney growth have been compiled. All kidney measurements were found to increase as pregnancy progressed. At 13 weeks, fetal kidneys and fetal urinary bladder were visualized in 92% of the cases screened. The incidence of pyelectasis was high in our population (4.5%), and this pathology was studied by other sonographic scans during pregnancy and postnatally. All fetuses had normal karyotypes. The results presented provide a reference for the assessment of normal renal morphology and growth in early pregnancy.

Female↗

[Visualization of the fetus in early pregnancy with transvaginal sonography].

The aim of this prospective study is to define in early pregnancy the time and percentage of visualization of embryo-fetal structures and organs. 820 patients at high risk for fetal genetic anomalies and/or malformations were scanned by high resolution transvaginal probe between 10 and 16 weeks' gestational age. Criteria for exclusion were: fetal malformations, multiple pregnancies and loss of pregnancy. We determined percentage of visualization in the different weeks of: orbits, face, cerebellum, cisterna magna, cardiac chambers, abdomen, diaphragm, stomach, kidneys and bladder. The percentage of visualization of fetal organs and structures investigated increased with gestational age and at 13 weeks ranged from 80% to 100%. With the introduction of high-frequency transvaginal probes in early pregnancy embryo-fetal structures and organs can be imaged and studied in great detail and more accurately identified than with traditional abdominal ultrasound, up to 4 weeks earlier. Another important advantage is the fact that some fetal malformations can be detected earlier.

Adult↗

Preoperative ultrasound assessment of omental spread in ovarian cancer.

The accuracy of high-resolution ultrasound in the detection of macroscopic omental metastases was evaluated in 50 consecutive patients undergoing surgery for ovarian cancer. Ultrasound provided an overall diagnostic accuracy of 83.7%, with a sensitivity of 76.6% and a specificity of 100%. The sensitivity in the diagnosis of diffuse omental involvement was 93.3%. Moreover, the overall diagnostic accuracy, sensitivity and positive predictive value of the method increased as the study progressed. In the last 25 cases examined, in fact, these values were 94.7, 90, and 90%, respectively.

Adult↗

A novel inositol mono-phosphatase inhibitor from Memnoniella echinata. Producing organism, fermentation, isolation, physicochemical and in vitro biological properties.

A novel inositol mono-phosphatase inhibitor, L-671,776 (1), was discovered from a culture of the hyphomycete, Memnoniella echinata (ATCC 20928). 1 has a molecular weight of 388 and a molecular formula of C23H32O5. The mode of inhibition is non-competitive, with a Ki of 450 microM. It shows no inhibition of myo-inositol 1,4-bisphosphate 1-phosphatase or myo-inositol 1,4,5-triphosphate 5-phosphatase, although it weakly inhibits myo-inositol 1,4,5-triphosphate 3-kinase (IC50 = 3 mM). It elevates inositol monophosphates in rat parotid slices (EC50 approximately 3 mM), but abolishes agonist effects. It also produces short-lived contraction of guinea pig trachea at 300 microM.

Animals↗

Ovarian fibrothecoma: sonographic and histologic findings.

The sonographic and histologic findings observed in 11 cases of ovarian fibrothecoma were compared, and an attempt was made to find a correlation between each histologic type of the tumor (pure thecoma, predominantly fibrous fibrothecoma, mixed fibrothecoma) and its sonographic appearance. The presence of a homogeneous echogenic pattern, with marked posterior acoustic shadowing, in the absence of any calcification, was highly suggestive of a predominantly fibrous ovarian fibrothecoma; the presence of a diffusely hypoechoic ovarian mass, with no posterior echo enhancement, was strikingly correlated with pure thecomas; mixed fibrothecomas were characterized by the presence of an echogenic pattern with no posterior acoustic shadowing. Sonographic findings, even though nonspecific, can provide the clinician with useful information which permits to detect these rare neoplasms preoperatively.

Adult↗

Transvaginal ultrasound evaluation of myometrial invasion in endometrial carcinoma.

In 20 cases of histologically proved endometrial cancer the depth of myometrial invasion was ascertained by means of transvaginal ultrasound, using a high-frequency endocavitary probe. The sonographic findings were confirmed by histologic examination in 18 of the 20 patients evaluated (90.0%). Transvaginal ultrasound provides a fuller preoperative clinical picture and supplies additional diagnostic information which is invaluable in the choice of therapeutic approach.

Adult↗

Ovarian carcinoma: an ultrasound study.

Between March 1986 and March 1989, 65 epithelial ovarian carcinomas were studied by means of real time high resolution ultrasound. The sonographic findings were correlated with FIGO stage, histotype and histological grade. The echostructure was compared with that of a group of 141 benign controls. Moreover, some sonographic patterns, significantly more frequent in the malignant tumors (ascites, irregular borders, peritoneal growths), were identified. The diagnosis of malignancy was as accurate as 90.0%, sensitivity and specificity were 84.7% and 92.3% respectively. Our results, coupled with the low costs involved and the non-invasiveness of the method, thus confirm that ultrasound can still be considered a primary technique in the preoperative assessment of ovarian masses.

Adenocarcinoma↗

Pelvic lymphocele following radical para-aortic and pelvic lymphadenectomy for cervical carcinoma: incidence rate and percutaneous management.

Thirty-six women, treated with radical hysterectomy (Piver types III-IV) plus systematic para-aortic and pelvic lymphadenectomy for cervical carcinoma, underwent serial postoperative ultrasound examinations to determine the incidence of lymphocele and the therapeutic efficacy of percutaneous catheter drainage. Pelvic lymphoceles, ranging in volume from 46-300 mL, occurred in eight patients (22.2%) between the 12-24th postoperative day. Percutaneous catheter drainage, inserted under local anesthesia, was used for a mean time of 14.5 days (range 4-32), resulting in a mean daily drainage of 92.2 mL and a mean total volume of 1727.5 mL per patient. Catheter drainage allowed complete clinical and sonographic remission in all cases, and only one asymptomatic recurrence was observed at 3-month and 6-month follow-up. Ultrasound-guided percutaneous catheter drainage has proved to be a well-tolerated, safe, and effective technique in the management of lymphocele that obviates the need for more invasive surgical procedures.

Drainage↗

In vitro motility of non-pregnant rat uterine horns.

The in vitro spontaneous mechanical and electrical activity of the non-pregnant rat uterine horn was investigated. An isometric isovolumic preparation was used to obtain records of intraluminal pressure, axial force, extracellular electrical activity and horn morphology. Mean intraluminal pressure was 28.6 cmH2O and mean force 2.5 g. Burst electrical activity was initiated at the ovarian end in 70% of the cases. Detailed analysis of electrical and mechanical events during a single contraction showed a preparatory phase involving the longitudinal muscle layer, followed by a stronger contractile event involving both longitudinal and circular layers. Moreover, the mechanical activity was modulated at the frequency of a component (0.16-0.20 Hz) of the slow electrical activity of the horn. Burst electrical activity appeared at five equidistant electrodes along the horn with variable delays: the highest delays (mean values 7.4 s for burst activity initiated at the ovarian end and 6.5 s at the vaginal end) were observed in the middle part of the horn. The spontaneous contraction of the segment appeared to be due to the activation of separate regions of the horn (i.e. an ovarian and a cervical region), more than to a propagated excitatory action.

Action Potentials↗

Effects of intra-amniotic isoxsuprine on amino acid placental transfer in rats.

Direct administration of isoxsuprine to the rat fetus increases placental transfer of 35S-methionine and this increase is statistically significant on day 17 as compared with intraperitoneal administration and controls (p less than 0.01; p less than 0.05). In contrast, no statistically significant differences were found between the groups on day 16.

Amino Acids↗