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Biomedical subjects

N Borsato

Publications and source records attributed to N Borsato.

At least 37 records · Page 2Linked to original sources

Single-photon emission computed tomography studies with 99mTc-hexamethylpropyleneamine oxime in dementia: effects of acute administration of L-acetylcarnitine.

The acute effects of intravenously administered L-acetylcarnitine (LAC) were evaluated with single-photon emission computed tomography (SPECT) and 99mTc-hexamethylpropyleneamine oxime in 30 demented patients (21 with a clinical diagnosis of Alzheimer's dementia and 9 with mixed-type dementia). Two SPECT scans were performed: in basal conditions, and 30 min after the administration of 500, 1,000, 1,500, or 2,000 mg LAC intravenously. Tracer activity ratios were determined in 10 pairs of cerebellar, cortical and subcortical regions. After administration of the lowest dose of LAC, no changes from the basal values were observed in any of the regions examined. The higher doses of the drug significantly elevated the tracer activity in cortical regions, particularly in the parietal lobe, which showed an impaired regional cerebral blood flow in the basal study. These effects of LAC and their relation with the cholinomimetic properties of the drug are discussed.

Acetylcarnitine↗

Scintigraphy of the parathyroid glands with 201TI: experience with 250 operated patients.

Parathyroid scintigraphy confirmed its validity in the preoperative localization of enlarged parathyroids, showing a sensitivity of 82% in a series of 250 patients suffering from primary hyperparathyroidism and successfully operated on. The glands better visualized were in an ectopic site or they were completely or partially outside the thyroid so that they were easily visible without employing digital image subtraction. This is nevertheless necessary to visualize parathyroids in a retrothyroid site but some problems arise, related not only to movements of the patient but also to the instrumentation to perform a correct image subtraction.

Adenoma↗

[99mTc]-HM-PAO SPECT in Parkinson's disease.

Thirty-six patients affected by Parkinson's disease were studied using single photon emission computed tomography (SPECT) and [99mTc]-HM-PAO as a tracer. The scanning procedure was performed 16-24 h after discontinuation of specific therapy. Tracer activity ratios were determined in 10 pairs of cerebellar, cortical, and subcortical regions. Data were compared with those of 10 age-matched controls. Most of the regions examined did not show any relevant change between parkinsonian and control subjects. Notably, mean activity in striatal regions were similar in the two groups. Increased activity in caudate-putamen was found in patients who were on chronic DOPA therapy. Side-to-side asymmetries in the basal ganglia increased with the severity of the disease. Significant reductions of tracer uptake, from control values, were observed bilaterally in the parietal cortex. These deficits were more pronounced in patients with mental deterioration and in subjects who had been chronically treated with anticholinergic drugs. Parietal perfusion deficits in parkinsonian patients resemble those described in Alzheimer's dementia. These findings suggest that the heterogeneous alterations of regional cerebral blood flow (rCBF) in parkinsonian patients reflect the multifactorial pathophysiology of the disease.

Adult↗

Radionuclear determination of glomerular filtration rate and renal plasma flow to detect early decrease of renal function in insulin dependent diabetes.

To evaluate the role of renal haemodynamic factors in the pathophysiology of diabetic nephropathy, we determined by radionuclear techniques glomerular filtration rate (GFR) and renal plasma flow (RPF) in 18 patients affected by insulin dependent diabetes mellitus (IDDM) in good metabolic control, with normal blood pressure and plasma creatinine. GFR and RPF measured in the same patients after ten months correlated with proteinuria and duration of diabetes. Our finding of a significant correlation between the decline of RPF and duration of diabetes may support the haemodynamic hypothesis of progression of diabetic nephropathy.

Adolescent↗

Parathyroid localization in primary hyperparathyroidism: double-tracer scintigraphy and venous sampling techniques combined. A first evaluation.

The authors report their first experience with two techniques for preoperative localization of hyperfunctioning parathyroid glands: double-tracer (99mTc-201Tl) scintigraphy and venous sampling from thyroid veins. Nineteen patients affected by primary hyperparathyroidism were examined by both methods and subsequently submitted to surgery. Scintigraphy showed a sensitivity of 77.3% while the positivity of sampling was 63.6%; with the two techniques combined a correct localization was obtained in 90.9% of all cases. The authors emphasize the usefulness of both methods combined for locating enlarged hyperfunctioning parathyroids.

Adenoma↗

New perspectives in localizing enlarged parathyroids by technetium-thallium subtraction scan.

Double-tracer scanning (Tc-99m as pertechnetate and Tl-201 as chloride) with an Anger camera and computerized image subtraction was performed in 61 patients whose clinical and biochemical findings had suggested primary hyperparathyroidism. This study showed intra- or extrathyroidal focal uptake of thallium in 37 cases. Among these, 24 patients underwent surgery, and 18 parathyroid adenomas, five carcinomas, and one hyperplastic gland were found exactly in the sites predicted by scintigraphy. Among 24 patients with negative scans, only two underwent surgery; a hyperplastic parathyroid gland (diam less than 0.5 cm) was found in both. The success rate was 92% in the cases in which operation was performed. We believe that the new method may be useful in the preoperative detection of parathyroid enlargements.

Adenoma↗

[Basal prolactinemia and level after stimulation with TRH in juvenile gynecomastia].

TSH and PRL in basal conditions and after stimulus with TRH, gonadotrophin in basal conditions and after stimulus with GnRH, plasma testosterone, urinary oestrogens and peripheral thyroid hormones have been evaluated in 11 subjects with puberal gynaecomastia, 7 with post-puberal gynaecomastia and 14 normal controls. With respect to the normal controls, only patients with post-puberal gynaecomastia showed higher levels of basal PRL and after TRH stimulus. The behaviour of these patients could suggest that in subjects with post-puberal gynaecomastia there may be persistent endocrine imbalance, whereas in puberal gynaecomastia such imbalance is only transitory and is exhausted prior to the onset of mammary tumefaction.

Adolescent↗

Positive 131cesium scanning in parathyroid adenoma.

In a case of primary hyperparathyroidism, a palpable nodule, at the base of the right lobe of the thyroid, proved 'cool' during 99mTc scanning, but 'hot' when scanned with radiocesium. The uptake of this tracer was higher than the uptake of 75Seselenomethionine after suppression with T3. The authors discuss the possibility of cases of 'false-positive' radiocesium uptake in extrathyroid nodules, and in particular, the use of this tracer for the detection of parathyroid adenoma by scanning.

Adenoma↗

An immunological investigation of factor VIII associated antigen in combined factor V and factor VIII deficiency.

The behavior of factor VIII associated antigen of three patients with combined factor V and factor VIII deficiency has been evaluated in several immunological systems. Factor VIII associated antigen resulted to be normal or higher than normal in all three patients in the radial immunodiffusion and in the electroimmunoassay systems. In the bidimensional electrophoresis system only one factor VIII precipitate was evident and such factor VIII precipitate showed the same electrophoretic mobility as normal factor VIII antigen. These findings firmly establish the fact that the factor VIII defect in congenital combined factor V and factor VIII deficiency is of the hemophilia type.

Antigens↗

The "echis carinatus venom" prothrombin assay in coumarin treated patients. A comparison with one-stage and immunological assays.

Prothrombin (factor II) was assayed in a group of coumarin treated patients using the Echis carinatus venom as thromboplastin. The levels obtained were comparable to those observed using the classical one-stage method. A good correlation was in fact observed between the two methods. The levels observed by the Echis carinatus method were definitely lower than those obtained using two immunological methods indicating that Echis carinatus venom activated, in our system, only normal prothrombin. However, even the levels obtained immunologically were slightly decreased, regardless of the method used, as compared to pooled normal plasma. In congenital prothrombin deficiency (homozygotes and heterozygotes) the level obtained by the Echis carinatus method was comparable to that observed by the one-stage method. On the contrary, in a congenital dysprothrombinemia (prothrombin Padua) a normal level was observed whereas the one-stage and two-stage methods yielded constantly levels of about 50% of normal.

Animals↗

Factor X Friuli: An immunological study in plasma and in serum using several methods.

An immunological study of factor X Friuli was carried out using an anti-human-factor X antiserum. The results obtained with different methods were compared. Only an ill-defined factor X band or precipitate was evident on standard immuno-electrophoresis and on immunodiffusion. Using a non-absorbed antiserum a precipitate was evident on eletroimmunoassay, in normal, factor X Friuli and in factor X deficient plasma. On the contary, using an antiserum which had been previously absorbed with factor X deficient plasma, a precipitate was evident only with factor X Friuli plasma or normal plasma. Excellent results were obtained with the cross-over electrophoresis. Using this method a major or factor X band was evident in normal plasma, factor II,P FACTOR VII, factor IX deficient plasmas and in the factor X FRIULI PLASMA. No factor X band was evident in factor X deficient plasmas and in absorbed normal plasma. Lighter, more cathodic bands were seen in all plasmas. These were due to secondary activities of the antiserum and could be disregarded. Friuli serum factor X and normal serum factor X showed a slightly more anodic migration as compared to their plasma counterparts. In coumarin plasma two factor X bands were evident; one normal in position and one slightly more catholidic. In the bidimensional immunoelectrophoresis two precipitates are visible in normal plasma and in factor X Friuli plasma. In factor X deficient plasma only one precipitate is evident. This latter precipitate is due to the secondary activity of the antiserum used. On the basis of these data it is concluded that factor X Friuli behaves, immunologically, as normal factor X.

Blood Coagulation Disorders↗

Prognostic evaluation of patients after myocardial infarction: incremental value of sestamibi single-photon emission computed tomography and echocardiography.

BACKGROUND: This study compares the prognostic value of 99mTc-labeled methoxyisobutyl isonitrile (MIBI) single-photon emission computed tomographic (SPECT) imaging, echocardiography, and other clinical and laboratory prognostic factors in the long-term risk stratification of patients with stable uncomplicated infarcts. METHODS AND RESULTS: Ninety-one consecutive patients affected by a first myocardial infarction without serious complications were enrolled. After at least 3 months from the infarction, they were submitted to stress-rest MIBI SPECT and rest echocardiography. Eighty-six patients completed a follow-up of at least 4 years (range 48 to 72 months; mean 55 months). By univariate (log-rank test) and multivariate analysis (Cox proportional hazards model), the main clinical, electrocardiographic, scintigraphic, and echocardiographic findings were evaluated and correlated statistically with the incidence of ensuing cardiac events. Twenty-five patients had cardiac events during the follow-up (four cardiac deaths, four myocardial infarctions, and 17 cases of unstable angina). At the multivariate analysis, the presence of reversible defects on MIBI SPECT (p = 0.008 and relative risk [RR] = 7.09), the wall motion score index, and the ejection fraction at echocardiography (respectively, p = 0.010, RR = 3.67, p = 0.036, and RR = 3.12), and stress angina (p = 0.007 and RR = 3.40) were significant and independent prognostic factors. CONCLUSIONS: In our long-term follow-up, MIBI SPECT and echocardiography appeared to be significant and independent prognostic tools in the risk stratification of patients with stable, uncomplicated infarcts, furnishing complementary information. The reversibility of MIBI defects appeared the best indicator for a bad prognosis.

Echocardiography↗

Treatment of secondary hyperparathyroidism with low dose intermittent calcitriol in hemodialysis patients. Imaging and cost analysis.

Calcitriol therapy is effective in the treatment of secondary hyperparathyroidism both during intravenous and oral administration, but there are doubts about the length of therapy and the duration of results. There are conflicting reports about results in size and activity of enlarged glands studied by ultrasound and double-tracer-subtraction-scintigraphy (DTSS). In 12 patients, 1 microgram of calcitriol was administered three times a week, intravenously and orally in alternate modes, for 46 weeks (therapy period) and orally for 46 weeks (follow-up period). During therapy, parathyroid hormone levels decreased in all patients, and in eight decreased by about 50% and were maintained at low levels during follow-up in five patients. Nine enlarged glands were detected by ultrasonography at the start of the study, and four hotspots were detected by DTSS; ultrasonography and DTSS were repeated at the end of the therapy and at the end of the follow-up: ultrasonography did not yield any significant variation in size, while one hot spot disappeared on DTSS. Basing their judgment on the lower cost of oral rather than intravenous administration, and on the good results of oral therapy, the authors stress the advisability of taking into account clinical and financial considerations before choosing the route of administration.

Administration, Oral↗