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Biomedical subjects

R Romagnoli

Publications and source records attributed to R Romagnoli.

At least 19 recordsLinked to original sources
PubMed1995

Esophageal replacement: gastric tube or whole stomach?

BACKGROUND: The stomach can be used either in its entirely or as a greater curvature tube for esophageal replacement. METHODS: The study compares the gastric tube (group A; n = 112) to the whole stomach whose lesser curvature is denuded (group B; n = 100) in terms of technical complication and alimentary comfort. The clinical results are substantiated by assessment of the eating performance of patients and control subjects at a test meal, measurement of the gastric dimensions before and after both tailoring procedures, and intraarterial staining of the gastric wall. RESULTS: Major differences between the two groups are cervical anastomosis stenoses (22.3% versus 6% [A versus B]; p = 0.008), fistulas (7.9% versus 1%; p = 0.0209), number of meals and snacks per day (4.6 versus 4; p = 0.0275), sensation of early fullness at meals (52.4% versus 17.8%; p < 0.0001), ratings given to the long-term alimentary comfort (presymptomatic condition = 10 points) (7.6 versus 8.8 out of 10 on average; p < 0.0001), and calories consumed in 1 minute at a test meal (59% [p < 0.05] versus 77% of those consumed by control subjects). The volume of the stomach is reduced by a range of 21.4% to 47.2% after tubulization (group A) whereas it increases by a range of 4.9% to 17.4% after denudation of the lesser curve (group B). Intraarterial staining of the gastric wall reveals the poor vascularity of the upper-most segment of the greater curve. CONCLUSION: Slight increase of the gastric capacity and maintenance of the submucosal vascular network account for the better results achieved with the whole stomach.

Adolescent↗
PubMed1995

Thrombomodulin levels in insulin-dependent diabetic patients with microalbuminuria.

Thrombomodulin (TM) plays an important role in the regulation of blood coagulation at the endothelial surface. TM is also present in plasma, where an increase of its level seems to reflect endothelial damage. Since microalbuminuria is associated with an increased atherothrombotic risk and is considered an expression of widespread vascular damage, we evaluated plasma thrombomodulin levels, blood pressure, and plasma lipid values in Type 1 diabetic patients with micro- and normoalbuminuria. Thrombomodulin was measured in 12 microalbuminuric (albumin excretion rate 20-200 micrograms min-1 in 2 of 3 overnight urine collections) and in 12 normoalbuminuric (albumin excretion rate < 20 micrograms min-1) Type 1 diabetic patients matched for age, sex, body mass index, smoking habits, diabetes duration, and glycated haemoglobin. Mean thrombomodulin was significantly higher in micro- than in normalbuminuric group (59.34 +/- 3.58 vs 43.56 +/- 3.52 ng ml-1 p < 0.01). Systolic and diastolic blood pressure were significantly higher in micro- than in normoalbuminuric group (p < 0.05). There was a positive correlation between plasma thrombomodulin and albumin excretion rate (p = 0.013, r = 0.49), and between thrombomodulin and diastolic blood pressure (p = 0.023, r = 0.46) in diabetic patients as a whole but not in the individual groups. These findings suggest the presence of an endothelial injury in microalbuminuric patients.

Adult↗
PubMed1992

[The magnetic resonance of small hepatocarcinoma. A comparison with echography, computed tomography, digital angiography and computed tomography with lipiodol].

Diagnostic techniques as a whole and periodic ultrasonography (US) in particular frequently allows tumors < 3 cm (small hepatocellular carcinomas) to be detected in patients suffering from liver cirrhosis. Multifocal diseases are a major limitation to surgery. Recently, MR imaging has shown its capabilities in the diagnosis of small hepatocellular carcinomas. In our study the diagnostic value of MR imaging was compared with that of US, of pre- and post-contrast CT, of digital angiography and of CT after lipiodol injection (Lipiodol CT). The morphologic and signal intensity MR features of small hepatocellular carcinomas were investigated. Fifteen cirrhotic patients with 31 nodules of hepatocellular carcinoma < 3 cm were examined. All patients were studied with US, MR imaging, angiography and Lipiodol CT; 12/15 patients underwent CT. Histologic confirmation was obtained in 12 nodules (2 at surgery and 10 by means of percutaneous biopsy); in the extant 19 cases the diagnosis was made by combining US, CT, MR, angiographic and lipiodol-CT findings; in 9 tumors < 1 cm Lipiodol retention one month after angiography was considered as diagnostic. MR imaging detected 21/31 nodules (63%), US 22/31 (66.6%), CT 12/24 (50%), angiography 24/31 (74%), lipiodol CT 29/31 (92.5%). Mc Nemar test showed no difference in sensitivity between MR imaging and CT, MR and angiography, MR and US, lipiodol CT and angiography; however, the differences between the detection rates of MR imaging and Lipiodol CT and CT and lipiodol CT and US were statistically significant (p < 0.05). The difference in sensitivity between the detection rates of lipiodol CT and US was just above the threshold value which is usually considered significant (p = 0.065). One false positive was observed on US and none with MR, CT, angiography and lipiodol CT. On Se T1-weighted images 18 nodules were hyperintense, 2 isointense and 2 hypointense; on proton-density images 14 nodules were hyperintense, 7 isointense and none hypointense. On SE T2-weighted images 18 nodules were hyperintense, 3 isointense and none hypointense. A pseudocapsule was seen in 10/17 nodules (58%), especially on T1-weighted images. Accuracy and limitations of each technique and morphologic and signal intensity MR findings of small hepatocellular carcinoma are discussed. We believe that US is still the best diagnostic technique for the screening of hepatocellular carcinomas in cirrhotic livers.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1991

[Spin-echo anatomy of the larynx with magnetic resonance at 1.5 T].

The larynges of 8 healthy and informed volunteers were studied with a superconductive MR unit at 1.5 T together with those of 10 patients with extralaryngeal pathologic conditions. The study was performed with round surface coils (5") and with dedicated sellar coils in the anterior neck. Slices were 5 mm thick, and acquired on the coronal, axial, and sagittal planes, with T1-weighting; axial scans were repeated in the same locations with double echoes, with proton-density and T2-weighting. Five patients underwent additional scans after Gd-DTPA. The larynx of a semi-frozen cadaver was examined with sellar surface coils, on similar scanning planes and with similar pulse sequences to those described above; the larynx was removed, investigated with mammographic technique, and subsequently analyzed with thin CT slices and a high-resolution reconstruction algorithm for the study of laryngeal cartilage. Axial anatomical sections were then compared with MR and CT scans, and the anatomical structures were recognized on the triplanar MR scans of a volunteer's larynx. Besides MR anatomy of supporting laryngeal structures, the authors describe in detail the muscles, plicae, spaces and cavities which can be identified on the various planes, together with the changes in signal after Gd-DTPA.

Contrast Media↗
PubMed1990

Evaluation of ischaemic necrosis of carpal bones by magnetic resonance imaging.

Nine patients with chronic pain in the wrist were examined by M.R.I. to evaluate its accuracy in the detection of ischaemic necrosis of carpal bones. In seven patients, M.R.I. confirmed scintigraphic and radiographic signs of ischaemic necrosis. In two patients with radionuclide accumulations, M.R.I. did not confirm the diagnosis: in one, M.R.I. was totally normal and in the other it showed signs of a healing scaphoid fracture. From this limited experience, M.R.I. seems to be a sensitive imaging modality which is more specific than scintigraphy.

Carpal Bones↗
PubMed1990

[Doppler flowmetry in the study of portal hypertension in patients with liver cirrhosis. Qualitative and quantitative analyses].

The recent development of the duplex-Doppler technique, which combined real-time US with pulsed Doppler flowmetry, has allowed the flowmetric hemodynamic study of large abdominal vessels. As yet, however, both accuracy and possible applications of this method in the study of portal hypertension have not been fully investigated. This study was aimed at assessing whether or not the combined use of Doppler flowmetry and bidimensional US is able to detect portal hypertension in patients with liver cirrhosis (LC), and could therefore represent a valid alternative to endoscopic, angiographic, and direct pressure measurement techniques. Twenty-six patients with LC and 25 control patients were studied with a strictly standardized method; portal hypertension was detected in the patients with LC by EGDS and laparoscopy. The results demonstrated pulsed duplex-Doppler US to be able to detect portal hypertension in 92.4% of LC patients, with 2 false negatives only (7.6%). The difference in the flowmetric data of normal and LC patients was highly significant (p less than 0.001 Student's t test). In conclusion, duplex-Doppler US can be considered as a valid technique to detect portal hypertension in LC patients, and can thus be used as an alternative to more invasive techniques of general use in clinics.

Adult↗
PubMed1989

[Rotator cuff lesions: evaluation with RM and US].

Physical and instrumental examination of the patients with an "aching shoulder" is often difficult and a positive out-come of surgical treatment may be impaired by the late diagnosis of long-standing rotator cuff lesions causing tendon adhesions and muscle atrophy. The authors report the results obtained in 25 selected patients with an aching shoulder examined with arthrography, real-time ultrasound (US) with a 5 MHz linear probe, and high-field (1.5 T) Magnetic Resonance (MR) imaging. Arthrography was able to demonstrate a cuff tear in 14/25 cases; US detected signs of tear in 14/25 (1 false negative); MR imaging showed a cuff lesion in 16/25 patients, and in one case allowed a partial cuff tear to be demonstrated, which had not been visualized with arthrography. MR imaging could also demonstrate other signs of periarticular pathologies (tendinitis, longhead of biceps inflammation, and bursitis) that may represent the early stages of the inflammatory-degenerative process underlying most of cuff lesions. The high diagnostic accuracy of US (95%) is stressed in the detection of cuff tears, in patients with an aching shoulder; as for questionable cases at US, MR imaging is indicated as a valid alternative to arthrography, which is more invasive and less accepted by the patients.

Arthrography↗
PubMed1989

[1.5 T MR in the diagnosis of parotid masses: comparison with ultrasonography].

Twenty-two patients who presented with laterocervical retromandibular enlargement were examined with both US and MR imaging to assess the intrinsic/extrinsic relationship of the mass to the parotid gland, the involvement of the facial nerve and adjacent structures, as well as the nature of the mass. Both US and MR imaging proved to be poorly specific in the characterization of the inflammatory lesions. Within the mass, both methods revealed high sensitivity (100%) in identifying the lesions, even very small ones. MR imaging allowed the lesion to be accurately located, the facial nerve to be identified, and its possible infiltration to be evaluated, with higher reliability than US, thanks to its higher contrast resolution and to its multiplanarity. Neither US nor MR imaging allowed the benign/malignant nature of the lesion to be assessed. On the basis of their experience, the authors suggest the use of T2-weighted MR sequences, with long TR and TE, to differentiate pleomorphic adenomas from other histotypes, after US assessment of the solid nature of parotid masses.

Adenocarcinoma↗
PubMed1989

[1.5-T MR of the knee: the correlations with arthroscopy].

The authors report their experience of knee articular pathologies studied with MR imaging. Forty patients (36 with and 4 without articular trauma) were examined with both MR imaging and arthroscopy. Arthroscopic findings were correlated with MR results in order to evaluate the accuracy of the latter in detecting meniscal tears. MR images were obtained with a 1.5 T unit and a transmit-receiver surface coil. Spin-echo sequences and, occasionally, fast-scan sequences were used both in the coronal and in the sagittal planes. High resolution MR imaging clearly depicted knee anatomy. As far as meniscal lesions were concerned, the authors employed a grading system to classify intrameniscal signals, as proposed by Lotysch. The preliminary results are encouraging and suggest the use of MR imaging as the first imaging modality for use in knee pathology before arthroscopy is performed.

Adolescent↗
PubMed1989

[Cystic lesions of the mucosa of the maxillary sinus. Clinical considerations and differential diagnosis].

The various pathogenic, radiological and clinical aspects of cystic lesions of the maxillary sinus mucosa (pseudocysts, retention cysts, mucocells) are examined together with related problems of differential diagnosis. Such lesions are sometimes found accidentally in the course of routine X-rays or on the basis of clinical indications not directly attributable to the presence of a cyst. Often they are completely asymptomatic so that they are less often recognised than their true incidence and are sometimes confused with maxillary sinus lesions of a totally different origin. In the personal experience described sinusoscopy proved a valuable adjunct to clinical and radiological investigations for the purposes of differential diagnosis and may in some cases form the first stage of treatment. The value of sinusoscopy is also enhanced by the possibility it offers for targeted biopsies at the same time.

Cysts↗
PubMed1987

The computed tomographic appearances of cherubism.

The computed tomographic (CT) aspects of six cases of cherubism are described. Through its optimal representation of the lesions, CT enabled certain characteristics of this disease to be substantiated, namely, limitation of the process to the bones of the jaw and primarily superficial development of the mandibular lesions, coupled with an unusual mandibular condylar impairment. Moreover, the composition of this series permitted investigation of the condition in its several stages of progression.

Adolescent↗
PubMed1987

Diagnostic approach to pulmonary lymphangioleiomyomatosis. Case report.

A diagnosis of lymphangioleiomyomatosis is to be considered in women with pleural chylous effusion when plain chest films show diffuse interstitial changes, possibly associated with cystic-like spaces and overinflation. The CT, showing the presence of a retroperitoneal mass, can ultimately help to outline the diagnosis of this syndrome as in the personal case observed in a postmenopausal woman. A presumptive pre-surgical biopsy diagnosis can be useful for studies of hormone-receptors and may be clinically relevant.

Female↗
PubMed1986

Left partial absence of the pericardium.

A case of left partial absence of the pericardium in a young patient is presented. Plain roentgenographic findings were suggestive, and 2-D echocardiography was useful only to rule out associated cardiac abnormalities. Computerized tomography led to the diagnosis permitting to define some typical features.

Adolescent↗