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Biomedical subjects

M Lutman

Publications and source records attributed to M Lutman.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Computerized tomography in renal injuries].

CT scans were performed on 25 patients suspected of sustaining renal trauma. The utility of CT in both detecting renal damage and appraising the gravity of injuries was assessed. Nowadays, in fact, nephrectomy is reserved for lesions devastating the kidney parenchyma or rupturing the renal pedicle; so it is very important to identify both the kind of lesions, and the extent of the damage, for the purposes of a better planned therapeutic approach. CT does both, being more accurate than urography in the detection of renal fractures, intra or extraparenchymal hematomas and contrast media extravasation. Urography very often shows aspecific lesion patterns and sometimes it is also falsely negative. In the present series CT was more reliable than angiography itself, particularly in the diagnosis of extra-renal hematic collections, contrast media extravasation and injuries to the other abdominal organs. Although CT may arouse the suspicion of and sometimes correctly diagnose vascular lesions, such as renal infarction, angiography remains the choice examination in the study of vascular lesions, thanks to its characteristic and unmistakable images.

Hematoma↗
PubMed1986

[Computerized tomography in acetabular fractures].

The paper deals with sixteen cases of acetabular fractures studied with CT. After a short description of the normal CT findings, the different kind of fractures are reported. The usefulness of CT examination in evaluating acetabular fractures and their complications is confirmed both in conservative treatment and surgical approach.

Acetabulum↗
PubMed1986

[Role of computerized tomography in the TNM staging of laryngeal and hypopharyngeal neoplasms].

70 patients with squamous cell carcinoma of larynx and hypopharynx were examined by computed tomography; the TNM staging of tumors by CT, by endoscopy and by surgical operation was reviewed. CT proved to be reliable both to recognize the presence of neoplasms, with the exception of those very superficial, and their deep spreading to pre-epiglottic and para-laryngeal spaces, to the soft tissues of the neck and to the cartilages. Therefore CT is the examination of choice in laryngeal neoplasms staging, because it precisely completes the clinical and endoscopical informations.

Humans↗
PubMed1985

[Congenital aneurysm of the left atrial appendage].

Congenital aneurysm of the left atrial appendage is a rare anomaly, usually presenting in adult life. We report the case of a 31-year-old woman with a marked prominence of the upper left heart border at the chest X-ray in whom the diagnosis of congenital aneurysm of the left atrial appendage was confirmed by cross-sectional echocardiography and computed tomography. Up to few years ago angiography was considered the method of choice in establishing the diagnosis. Cross-sectional echocardiography has recently become a safe and reliable method for diagnosing congenital aneurysm of the left atrium and should be considered in any case with abnormality of the profile of left atrium on the chest radiography.

Adult↗
PubMed1983

Glucose interorgan exchange in chronic renal failure.

The mechanisms responsible for the altered glucose metabolism observed in chronic renal failure (CRF) were investigated in the postabsorptive state. In 11 patients with CRF and in 15 subjects with normal renal function, the hepato-splanchnic (HS), leg, and brain exchanges of glucose were measured; the HS exchange of gluconeogenic amino acids was also evaluated. Patients with CRF had normal glucose levels, whereas insulin levels and the ratio of insulin to glucose were significantly increased in comparison with controls. In CRF, HS glucose output was slightly lower in comparison with controls (0.46 +/- 0.04 vs. 0.57 +/- 0.04 mmoles/min X 1.73 m2 in controls; P less than 0.1). Arterial levels of alanine and glycine and their uptake by the HS bed were similar in both groups, but in CRF HS serine uptake disappeared, mainly as a consequence of a reduction of its fractional extraction. Conversely, a significant proline extraction became evident, primarily depending on the increased arterial levels of this amino acid. The total HS uptake of potential gluconeogenic amino acids was not different in the two groups, and its ratio to glucose output was increased in CRF (28.0 +/- 4.7 vs. 16.0 +/- 1.9 in controls). In CRF, the arterial-femoral venous differences of glucose were significantly reduced (0.11 +/- 0.04 vs. 0.25 +/- 0.04 mmoles/liter in controls), as was the fractional extraction of glucose in the leg. Finally, in CRF both glucose uptake and its fractional extraction by the brain were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗
PubMed1983

Branched-chain amino acid metabolism in chronic renal failure.

Interorgan exchange of branched-chain amino acids (BCAA) in the postabsorptive state was evaluated in 16 patients with chronic renal failure (CRF) and in 20 subjects with normal renal function, by measuring arterial-venous differences of BCAAs across the leg, brain, hepato-splanchnic (HS) bed, and kidney. In CRF, arterial blood levels of valine are significantly reduced, whereas leucine and isoleucine levels are not different from controls; valine and leucine levels are directly related to GFR. In CRF, a significant decrease in the release of valine by the leg is observed; the leucine release tends to be lower; for both these amino acids, leg release is directly related to their arterial levels. Both ratios of valine and leucine release to total amino acid release by the leg are significantly reduced in CRF. Furthermore, in CRF cerebral uptake and fractional extraction of valine and isoleucine are decreased. In normal subjects, valine and leucine are significantly extracted by the HS bed, whereas in CRF the HS uptake of valine and its fractional extraction fall significantly and leucine uptake is unchanged. The kidney releases significant amounts of leucine both in CRF and in controls. In conclusion, in CRF in the postabsorptive state the exchange of BCAAs, mainly valine, is altered rather early at the major sites of production and utilization, and the flux of these amino acids among the organs is decreased. The primary defect is the decreased output by peripheral tissue, which reduces the supply of BCAAs to the brain and HS bed. Regional metabolic disturbances further impair BCAA utilization.

Adult↗