[Radiology information system project at the National Tumor Institute of Milan].
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Biomedical subjects
Publications and source records attributed to M Borroni.
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A hydroxyapatite-coated hip prosthesis designed to stimulate proximal femoral stress transfer was studied in 222 patients undergoing primary total hip arthroplasty with a minimum followup of 2 years. The femoral component was a roughened titanium alloy with a 50-mu coating of hydroxyapatite applied to the proximal third. A proximal press-fit technique was applied with distal femoral over-reaming as standard procedure. The hydroxyapatite-coated acetabulum was of hemispherical design. Analysis of the clinical results showed a mean Merle D'Aubigné score of 16.7 points at 6 months and 17.4 points at 2 years. Mild residual thigh pain of unknown origin was reported in 3.6% of patients at 2 years. Radiographic evaluation showed complete acetabular and proximal femoral osseointegration without any loosening. No radiolucency or reactive line formation was observed around the hydroxyapatite-coated areas of the prostheses. Femoral bone densification occurred at the coated-uncoated transition zone (54%); 4% to 6% of cases showed cortical hypertrophy at the uncoated area of the stem. Reactive lines were seen around the distal stem in 52% of patients after 2 years. The clinical outcome was excellent, and the radiographic data pointed mainly to proximal femoral stress transfer.
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Nine patients underwent magnetic resonance imaging (MRI) as part of the diagnostic evaluation for cardiac masses; eight of them had been preliminarily studied by 2D-echocardiography (US). MRI did not add to the US diagnostic information in patients affected by intracavitary masses. It represented the definitive diagnostic modality in two patients with intramural pathology: one with ventricular rhabdomyoma, the second with an echinococcyal cyst located within the left atrial wall. The complementary role of MRI to US in cardiac masses is discussed.
For quantitative evaluation of cardiac dimensions by Nuclear Magnetic Resonance (NMR), we compared the values obtained by ECG gated NMR with those obtained by two-dimensional echocardiography (2D-echo) in 18 adult healthy volunteers aged 20-40 years (mean 31.6 +/- 5.8). NMR was performed using a 2 T super-conducting magnet operating at 0.5 T with a radiofrequency impulse of 21 MHz. Spin-echo pulse sequences with echo-delay times (TEs) of 30-45 msec were used for data acquisition. The interpulse interval was obtained from the R-R interval on the ECG. Slice thickness was set at 1 cm. To obtain planes oriented along the long axis of the left ventricle similar to 2D-echo, paraxial planes were obtained by double angulation. No significant differences of mean values obtained by NMR and 2D-echo were observed. Regression coefficients were not statistically different from 1 for any of the structures measured: left atrium (y = 1.106x), aorta (y = 1.077x), left ventricle (y = 0.66x), interventricular septum (y = x 1.009x), postero-lateral wall of the left ventricle (y = 1.133x), right ventricle (y = 1.093x). However high coefficients of variation were found for measurement of postero lateral wall (79.5) and interventricular septum (41.4) thicknesses; potential causative factors are discussed.
Urinary infections often complicate the clinical course of hospitalised patients especially those with immunological diseases or under antibiotic treatment for other infectious pathologies. Urethral catheterisation is also a well known cause of such infections. The problem of urinary infections was examined in a general medical division. Over a three year period (1982-84), 384 urinary tract infections (UTI) with one infecting organism and 21 UTI with two bacterial species in urine cultures were found. UTI was more often found to be caused by gram negative than gram positive bacilli in both catheterised and non-catheterised patients and E. Coli accounted for most infections. Pseudomonas, Serratia and Acinetobacter were only found in catheterised patients and Enterobacter cloacae almost exclusively so. Among gram-positive bacilli, Enterococcus was the most common. Staphylococcus aureus was rare but created major pathogenetic and therapeutic problems. The results are discussed with particular reference to the high incidence of Escherichia coli and the significance of the different distribution of Pseudomonas, Serratia, Acinetobacter and Enterobacter cloacae between catheterised and non-catheterised patients. Finally the pathogenic and therapeutic problems of UTI caused by more than one germ are considered.
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Severe fractures of the distal end of the femur, which have become increasingly numerous as a result of the multiplication of road accidents, frequently require surgical treatment. The Authors, updating to 1979 the cases of the "G. Pini" Orthopedic Institute in the field of Judet's screw-plate, document the validity of this means of synthesis as confirmed by the quality of the results.
Changes in total and individual plasma amino acid were examined in subjects with necrosis of the liver and acute insufficiency. Quantitative variations in single amino acids and their percentages were noted in all cases. The extent of such change and the number of amino acids involved were roughly proportional to the degree of insufficiency. A continuous and persistent increase in total blood amino acids can be regarded as a poor prognostic sign, especially if accompanied by a sharp fall in necrosis enzymes. Such an increase, in fact, was only observed in extremely serious cases.
Modern tendencies in the treatment of infected pseudarthrosis are discussed and compared with the methods of the recent past. Seventy four cases are analysed in detail. Fifty three were in the tibia, twenty six of which were treated by a standard modern technique consisting of osteomuscular decortication, excision of infected tissues and necrotic bone, external fixation and if necessary the addition of autoplastic cancellous grafts. The main purpose of this study was to analyse these results and assess the validity of this method.
The serum of patients suffering from Amanita phalloides poisoning was analysed in order to determine whether amanitines, which are the principal toxins of this fungus, were still present in the blood at the time of hospitalisation. In addition, the authors measured the concentrations of amanitines in the blood of dogs at different intervals after the ingestion of a fatal dose of Amanita phalloides. Amanitines were detected in the serum of 9 patients out of 16. This discovery, together with the finding that, in the dog, very low concentrations of amanitines in the blood are associated with fatal cellular lesions, suggests the need for very prompt action in order to eliminate these toxins from the blood as soon as the diagnosis of poisoning is suspected.
Severe fractures of the lower end of the femur have increased in frequency as road accidents have become more common. Good anatomical reconstruction is essential in order to conserve useful joint function, and this can only be achieved by internal fixation. Judet's screw-plate has been used with success in these cases and is presented in its technical and clinical aspects. The quality of the results obtained is documented in an analysis of 22 operations.
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Isodose curves can be viewed on multiple planes along with the radioactive implant and anatomical structures by projecting them on a video-display. The main options offered are the parallel projection of the implant selecting all the possible rotations, zooming and shifting, calculation of distance between two points of a selected plane, stereoscopic display.
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