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Biomedical subjects

M Mele

Publications and source records attributed to M Mele.

At least 19 recordsLinked to original sources

A new method for assessing 99Tcm-MDP bone uptake from a bone scan image: quantitative measurement of radioactivity in global skeletal regions of interest.

Bone uptake of 99Tcm-MDP was evaluated 4 h after injection in 27 normal subjects aged 23-50 years by gamma camera measurement of the activity in whole skeleton regions of interest (ROIs) in anterior and posterior projection. The mean global skeletal uptake (GSU) (% of whole-body activity in both projections measured 30 s after injection) was 33.5 +/- 4%. The standard urinary excretion method (whole-body retention, WBR) gave a mean bone uptake value of 31.5 +/- 4%. A significant correlation (r = 0.570; P less than 0.002) was found between GSU and WBR. The mean bone-to-soft tissue ratio (B/S index) was 3.0 +/- 1.1. It is suggested that this direct, external counting method provides a way of obtaining both a qualitative and a semiquantitative evaluation of bone uptake with a single tracer administration in a routine bone scan. Investigation of its use in the assessment of bone involvement in low and high turnover bone diseases is now under way.

Adult

Biochemical characterization of two angiotensin II receptor subtypes in the rat.

Two angiotensin II receptor subtypes, A and B, have been described by means of specific and selective ligands (Biochem Biophys Res Commun 1989; 163:284-91). The present report describes the binding characteristics and the distribution of these subtypes in various rat tissues. Adrenal and uterus expressed both subtypes but in different proportions. Subtype B predominated in the adrenal glomerulosa (60%), whereas there was a greater proportion of subtype A in the medulla (70%). In uterus, subtype B was preferentially expressed (70%), and there was no difference in receptor distribution between muscle layers and serosa. Liver, kidney, and cultured aortic smooth muscle cells expressed only subtype B. In all of the tissues tested, the Ki values of various competing ligands were similar for each subtype expressed. It is proposed that subtype B is the vascular receptor. The function of subtype A, however, is still to be determined.

Adrenal Glands

Cutaneous tuberculosis: atypical skin lesions in immunodepressed patients.

We report a case of secondary skin tuberculosis due to endogenous secondary infection in a 27-year-old subject affected by ulcerative colitis. The clinical appearance the lesion was atypical and its classification uncertain. The morphology of the lesion and the fact that the primary tubercular complex, at pulmonary level, was masked by a simultaneous candidiasis infection were probably due to cell-mediated immunodeficiency consequent to the ulcerative colitis and on-going therapy (Salazopyrin and prednisone). Rapid remission of cutaneous and pulmonary lesions was achieved following specific therapy (rifampicin, isoniazid, ethambutol).

Adult

[Maculo-papular juvenile xanthogranuloma. Considerations on a case].

A case of a 6-month-year old child with a yellow, macular and papular, asymptomatic, eruption involving the extremities, upper part of trunk and especially the head is reported. In the early stage histological and immunohistochemical studies were not contributory. Successively, the diagnosis of juvenile xanthogranuloma was made on the basis of the histological, immunohistochemical and ultrastructural findings. Problems of differential diagnosis are discussed.

Arm

Preliminary biochemical characterization of two angiotensin II receptor subtypes.

Two angiotensin II receptor subtypes (A and B) are described from rat and human tissues. They have been characterised using specific peptidic and non-peptidic ligands with affinities differing by 1000 fold or more. These subtypes are present in adrenal glomerulosa of both species. Human uterus contains only subtype A, whereas both subtypes are found in rat uterus. Vascular smooth muscle cells in culture express only subtype B. Dithio-threitol totally inhibits binding to subtype B, but enhances the affinity to subtype A. There is a good correlation between the affinities of the selected agonists and antagonists for the two subtypes in the various tissues tested which is a usual requirement for receptor classification.

Adrenal Glands

[Chronic follicular mucinosis. Presentation of a case].

Follicular mucinosis is a not uncommon but frequently misidentified disease. Actually this peculiar condition is divided in three groups: in one group the lesion cleared spontaneously within a few months (acute follicular mucinosis); in a second group there is a chronic relapsing but benign course over several years (chronic follicular mucinosis) and in a third group appeared in association with a lymphoma (15%). Some Authors believe that follicular mucinosis is a histological term for a reactive pattern in follicular epithelium. We report the case of a patient affected by this dermatosis. The eruption consisted of follicular papules and inflammatory plaques widespread. No instance of transition from follicular mucinosis to lymphoma was observed. Very important to the diagnosis was the histological findings. We believe that the case in exam was a form of chronic follicular mucinosis.

Alopecia

[Bone metabolism in thalassemic children with multiple transfusions. Compartmental analysis of 99mTc-Sn-MDP kinetics].

The kinetics of 99mTc(Sn) methylene diphosphonate [99mTc(Sn)MDP] were evaluated by means of compartmental analysis in 5 normal children and 17 thalassemic subjects. Blood and urine activity were analyzed with a computer program which generates intercompartmental rate constants by an iterative least-square method providing a best-fit to the input data. The amount of tracer in each compartment (corrected for decay) was determined as a function of time. The transfer rate of 99mTc(Sn)MDP from blood to extracellular fluid and lamellar bone (K1-3) was about 20% higher in thalassemic subjects than in normal children. The transfer rate of 99mTc(Sn)MDP from blood to woven bone (K1-4) was about 57% higher in thalassemic subjects. A faster rate of spread into woven bone appears to be the major cause of higher bone uptake of 99mTc(Sn)MDP in thalassemic subjects, which suggests that in these patients bone tissue reoccupies the space previously replaced by hyperplastic marrow. Moreover, the increased bone extraction rate revealed a correlation between anemia and bone metabolic activity.

Adolescent

[A new technic for esophago-enteral anastomosis with a mechanical stapler without purse-string sutures].

Staplers have improved the results of esophageal surgery, in our experience and in others experience, as esophago-enteric anastomoses have become safer and faster than when manual suturing is used. Probably one of the last problems in the stapler technique, especially in the thoracic area, is the performance of on adequate esophageal purse-string suture: an improper performance of this suture can cause a dangerous leak of the anastomosis. So, many surgeons, to reduce the risk of esophageal dehiscence connected with the esophageal purse-string, use either purse-string devices or alternative methods such as a second handsewn purse-string, U stitches of the esophagus, etc. We think that the risk of improper anastomoses after esophageal resection can be reduced if the need for the esophageal purse-string can be eliminated. This work shows our personal technique for performing esophagoenterostomy, especially in the thoracic area, using the new CEEA stapler (Autosuture) without esophageal purse-string sutures. According to the modified procedure the stapler anvil and the mini rod are introduced in the esophagectomy and a 2-0 thread is knotted around the CEEA mini rod. Then the esophageal mutilated part is closed by a linear stapler keeping a syringe needle, which contains the thread, through the linear suture. Then, using the thread as a pulling system, the surgeon makes the needle and the tip of the mini rod slide out of the esophageal suture. Now the surgeon can reassemble the CEEA and perform the anastomosis. There are many clinical reports that cite no leaks following circular stapled anastomoses across linear stapled closures.

Anastomosis, Surgical

Clearance kinetics and fate of macromolecular IgA in patients with IgA nephropathy.

IgA glomerulonephritis is associated with macromolecules of polymeric IgA in the circulation and mesangial deposits. An impairment in the reticulophagocytic function of patients with IgA nephropathy has been postulated as the potential cause for persistence of IgA immune complexes in the circulation and their eventual glomerular deposition. Since the fate and removal mechanisms of circulating macromolecular IgA are unknown in humans, we examined the blood clearance and organ uptake of purified IgA polymers and macromolecules in patients with IgA nephropathy and normal controls. The IgA macromolecules were prepared by covalent cross-linking of purified human polymeric IgA with a heterobifunctional reagent, N-succinimidyl 3-(2-pyridyldithio) propionate. After intravenous injection, large IgA molecules were removed rapidly from the circulation of patients (t1/2 = 3.8 +/- 1.0 minutes) and controls (t1/2 = 4.9 +/- 1.5 minutes). Dynamic gamma camera scintigraphy revealed the liver as the major organ that mediated the removal of the macromolecular IgA with no significant difference in the rate of hepatic uptake for patients (t1/2 = 3.4 +/- 0.6 minutes) and controls (t1/2 = 3.3 +/- 0.9 minutes). No significant amount of radioactivity could be detected in the lungs, kidneys, and spleen. The small polymers had a slower and similar clearance rates for patients (t1/2 = 29.3 +/- 7.9 h) and controls (t1/2 = 29.0 +/- 8.6 h). These findings have general significance in showing the liver as a major organ for removal of macromolecular IgA. In addition, the results have specific importance in showing that patients with IgA nephropathy do not suffer from an IgA removal dysfunction.

Adolescent

[Paresthetic notalgia. Report of 2 cases].

The Authors describe two cases of notalgia paresthesica, a disorder with localized pruritus of the back and hypesthesia for touch possibly due to a sensory neuropathy involving the posterior primary rami of thoracic nerve T2 through T6. The condition is not rare, but underdiagnosed for the poor clinical relevance. The possible X-linked hereditary transmission and other pathogenetic hypotheses are discussed.

Back

The early diagnosis of idiopathic femoral osteonecrosis.

Idiopathic osteonecrosis of the femoral head presents many problems of diagnosis and treatment during the early stages of the disease due to the paucity of clinical manifestations and the absence of radiographic evidence. By the time that the radiographic and clinical evidence are sufficient for a reliable diagnosis, the disease is so advanced that treatment is a problem. Early diagnosis is therefore the key issue and, in this context, instrumental tests, CT scanning and the measurement of blood flow velocity play an ever-increasing role. In the early stages of the disease CT scanning shows characteristic changes in the socalled "asterisk sign" of Dihlmann, and this has proved useful not only in terms of diagnosis, but also in order to initiate early treatment of the disease. Although radioisotope methods with double tracer do not allow for direct visualisation of the circulation in the femoral head, they have proved to be extremely reliable in evaluating the perfusion index of the femoral heads by providing activity/time curves which are a reliable estimate of regional blood flow.

Blood Flow Velocity

Renal perfusion in chronic liver diseases: evaluation by radiotechnetium renography.

Twenty-four patients with chronic liver diseases and seven normal controls were studied using renal and hepatic radiotechnetium angiography. The time-activity histograms generated were employed to calculate both the renal perfusion index (RPI) and the hepatic perfusion index (HPI). Renal perfusion proved to be reduced not only in cirrhotic patients but also in patients with aggressive chronic hepatitis, as well as in those with persistent chronic hepatitis. The HPI, which is to be considered as being strictly dependent on portal flow, only fell significantly in the group of cirrhotic patients. In all patients groups, the correlation coefficient between the HPI and RPI (mean of the two kidneys) was low (r = 0.275) and not significant (P greater than 0.05). After Warren's splenorenal derivation, renal perfusion did not improve but worsened, particularly in the left kidney where derivation anastomosis probably caused a venous overload.

Adolescent

Computer analysis of Tc-99m DPD and Tc-99m MDP kinetics in humans: concise communication.

Technetium-99m DPD and Tc-99m(Sn)MDP were compared regarding the quality of skeletal images and the compartmental kinetic data, in two groups of nine normal subjects. No difference in scan quality was found. Data derived from compartmental kinetic analysis suggest that MDP has a higher bone uptake and a lower soft-tissue retention in comparison with DPD.

Adult