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Biomedical subjects

R Toscano

Publications and source records attributed to R Toscano.

At least 19 recordsLinked to original sources
PubMed2006

Frequency rhythmic electrical modulation system (FREMS) on H-reflex amplitudes in healthy subjects.

AIM: Changes in the amplitude of Hoffmann reflex (H-reflex) may reflect variations in the characteristics of the largely monosynaptic circuitry that is explored and are a possible target for diagnostic and physical therapeutic intervention. However, previous attempts to induce predictable changes in the H-reflex amplitude by transcutaneous electrical nervous stimulation (TENS) have generally failed. Previous workers applied fixed frequency in the low- (2-5 Hz) or in the high- (100 Hz) field, but they did not attempt to vary frequency and/or impulse duration in time. METHODS: We evaluated the effect of a new type of painless electric stimulation, i.e. frequency rhythmic electrical modulation system (FREMS). FREMS is characterized by the use of transcutaneous electric pulses with sequentially modulated frequency (f: 1-39 Hz) and width (w: 10-40 micro s) at constant, perceptive threshold voltage (approximately 150 V). FREMS was applied at the abductor hallucis muscle (AHM), as conditioning stimulus of the H-reflex which was recorded ipsilaterally at the soleus muscle, according to the classic method, in 10 normal volunteers (age range 21-40 years). RESULTS: H-reflex amplitude was substantially decreased (-50%) during FREMS and H-reflex amplitude variations were influenced by w/f variation in time during FREMS subphase C in a predictable way (r(2)=0.43; P<0.001). Our results suggest an effective ability of FREMS to modulate H reflex amplitude. CONCLUSIONS: The ability to achieve large and predictable changes of the H-reflex amplitude simply by modulating both frequency and duration of a conditioning painless electrical stimulation offers new possibilities for the treatment of diseases characterized by motoneuron excitability abnormalities.

Action Potentials↗
PubMed2006

A simple method to find a robust output feedback controller by random search approach.

This paper presents a simple but effective method for finding a robust output feedback controller via a random search algorithm. The convergence of this algorithm can be guaranteed. Moreover, the probability to find a solution as well as the number of random trials can be estimated. The robustness of the closed-loop system is improved by the minimization of a given cost function reflecting the performance of the controller for a set of plants. Simulation studies are used to demonstrate the effectiveness of the proposed method.

Journal Article↗
PubMed2003

Diagnosis of the industrial systems by fuzzy classification.

The aim of this paper is to present a classifier based on a fuzzy inference system. For this classifier, we propose a parametrization method which is not necessarily based on an iterative training. This approach can be seen as a pre-parametrization which allows the determination of the rules base and the parameters of the membership functions. We also present a continuous and derivable version of the previous classifier and suggest an iterative learning algorithm based on a gradient method. An example using the learning basis IRIS, which is a benchmark for classification problems, is presented showing the performances of this classifier. Finally this classifier is applied to the diagnosis of a dc motor showing the effectiveness of this method.

Algorithms↗
PubMed2001

A new robotic endoscope manipulator. A preliminary trial to evaluate the performance of a voice-operated industrial robot and a human assistant in several simulated and real endoscopic operations.

We report our learning experience in simulated and real surgical tasks with a new voice-controlled robotic endoscope manipulator: an industrial robot with the tool-holder arm modified to support the optic and camera. The manipulator control-card programs have been rewritten to meet the needs of endoscopic surgeons. For this preliminary work, systems engineers with an additional monitor monitored, recorded, and compared the percentage effectiveness and precision of the responses of the robotic and human assistant to successive oral commands during the several different experimental surgical tasks. Simultaneously, to help develop this voice-commanded system for future, more precise robotic manipulation of surgical instruments, they measured the cartesian and spherical coordinates of successive positions of the optic. In unexpectedly difficult experimental conditions, the tireless robot proved more precise and effective than the demonstrably fatigable human: the steadier screen images of the robotic manipulations helped the surgeon tie knots in 7-0 sutures.

Animals↗
PubMed2001

Clustering of autoimmune thyroid diseases in children and adolescents: a study of 66 families.

Autoimmune thyroid diseases (AITD) are known to be clustered in families, but to what extent this occurs in childhood and adolescence is not well defined. In order to establish the prevalence of AITD in the siblings of affected children and adolescents, we examined 73 siblings from 66 families selected on the basis of a pediatric index patient. Sixty-six families, including a total of 146 offspring, were selected on the basis of diagnosis of chronic lymphocytic thyroiditis (CLT) (n = 55) or Graves' disease (GD) (n = 11). Among the 73 siblings examined, 20 new cases of CLT (27%) were detected. L-Thyroxine therapy was required in 4/20. History of AITD was recorded in 24/66 mothers (36%), and in two fathers. Overall in these families, considering both the index patients and the new patients, 86/141 (61%) children and adolescents were affected with AITD, with a female/male ratio of 3.3:1. Our study confirms that AITD clusters in families with a high prevalence in the siblings of affected children and adolescents. These children should be followed in order to avoid undiagnosed hypothyroidism. Prospective studies are warranted to identify predictive factors for overt thyroid disease.

Adolescent↗
PubMed1999

Simultaneous occurrence of Hodgkin's disease, nodal Langerhans' cell histiocytosis and multiple myeloma IgA(kappa).

A 35-year-old man suffered simultaneously from nodular sclerosis Hodgkin's disease (HD), Langerhans' cell histiocytosis and multiple myeloma (MM). There was no prior history of irradiation or chemotherapy, and clinically the lymphoma was confined to cervical lymph nodes. Immunohistochemically, neoplastic lymphoma cells reacted with CD15 and CD30 markers. The patient's bone marrow exhibited a diffuse infiltration by rather atypical plasma cells showing kappa immunoglobulin light-chain restriction. At 14 months after the diagnosis, after autologous bone marrow transplantation, the clinical evolution is favourable with complete remission of the diseases. This is the first time that the coexistence of these three haematological disorders has been discussed, and only the fourth documented case of simultaneous HD and MM. Speculations about the significance of this finding are discussed.

Adult↗
PubMed1999

Preperitoneal hernioplasty performed with needlescopic instruments (microlaparoscopy).

We treated a series of 30 patients who had a Nyhus type II, III, or IV inguinal hernia without associated pathology by laparoscopic surgery using 2-mm surgical instruments and a modified preperitoneal Dulucq technique. A 30 degrees optic was used, and the repair was reinforced by an accordion-folded, polypropylene mesh introduced through a 10-mm optic needleport. There were no postoperative complications, and all patients were discharged 24 hours after operation. At 6 months there has been no recurrence of hernia. It was evident that the 2-mm procedure produced less surgical trauma.

Hernia, Inguinal↗
PubMed1998

A new case of Ambras syndrome associated with a paracentric inversion (8) (q12; q22)

Ambras syndrome (AS) is a special form of congenital universal hypertrichosis described for the first time by Baumeister et al. (1). This form differs from other forms of congenital hypertrichosis in the pattern of hair distribution and its associated anomalies. The molecular-genetic cause of AS is unknown; the association of AS with a pericentric inversion (8) (p11.2; q22) described in the case of Baumeister so far has been unique in the literature. This report is the tenth with clinical signs of AS so far described in the literature and the second with an inversion in chromosome 8 and the first with evaluation of peripheral androgens. The new-born girl presented with abundant and dark hair on the face and ears, on the shoulders and on the arms; the other parts of the body were covered with fine, lightly pigmented hair. The face showed many dysmorphic features. Chromosome analysis showed a paracentric inversion of one chromosome 8. The breakpoints were localised at q12 and q22. The parental karyotypes were normal. Laboratory investigation showed normal plasma levels of testosterone, androstenedione (A), 17-hydroxyprogesterone, dehydroepiandrosterone-sulphate (DHA-S), free testosterone (FT), dihydrotestosterone (DHT) and 3alpha-androstanediol-glucuronide (3AG). Here we report a chromosomal inversion similar to that found previously not associated with alterations in androgen plasma levels.

Chromosome Inversion↗
PubMed1995

[Cytogenetic alterations found by chromosome analysis and fish technique in two patients with variant chronic lymphocytic leukemia].

Chromosomal studies in CLL have yielded poorer results than in other blood diseases because of the low mitotic index of the B cells. The FISH technique is a very useful tool for trisomy 12 detection in interphase nuclei in CLL, although this method cannot be a substitutive for conventional cytogenetics. The FISH technique was applied in two cases of CLL by means of satellite DNA probing specific for chromosome 12 according to the Oncor S 1370-CF kit protocol. Trisomy 12 was detected, along with other chromosomal abnormalities secondary to this trisomy. Both patients had lymphocyte counts lower than 5.0 x 10(9)/L and their peripheral blood immunophenotype showed 58% lymphocytes with lambda sIg of medium density, co-expressing CD5 and unable to form rosettes with mouse red-cells. Patient no. 1 was 46,XY/47,XY + 12/47,XY + 12,5q-, and patient no. 2 was 46,XX/47,XX + 12,14q-. The presence of secondary anomalies could explain the special clinico-haematological picture, characterised by low lymphocytosis and presence of irregular nuclei in mature lymphocytes, along with the lack of CD23 expression and rosette formation with mouse red-cells. FISH technique combined with chromosome analysis may prove a useful means for diagnosing and recognising variants or specific entities within low-grade lymphoproliferative syndromes.

Aged↗
PubMed1994

Indications and advantages of laparoscopy-assisted colon resection for carcinoma in elderly patients.

The controversy about laparoscopy assisted colectomy for cancer is based on doubt about performing a radical resection and adequate histopathological staging. Therefore, we selected a group of patients who could profit from the accepted benefits of the technique, while avoiding its uncontrolled outcome. We operated on patients with colorectal cancer with distant metastasis and on patients over 70 years old and American Society of Anesthesia (ASA) III-IV with a high operative risk with standard surgery. The results for the first 18 patients demonstrated the following: (a) the size of the surgical specimen and the number of lymph nodes were similar to those in standard surgery; (b) no mortality and very low morbidity occurred despite the patients' advanced age, debilitated condition, and comorbid diseases; (c) minor postoperative complications occurred in five of 18 patients; (d) the hospital stay was 6-7 days for nonmetastatic patients and 9-12 days for metastatic patients; (e) the 1-year survey revealed a relapse in only one patient 9 months after the first operation.

Aged↗
PubMed1993

Centroblastic transformation of chronic lymphocytic leukaemia with primary skin involvement--cutaneous presentation of Richter's syndrome.

The development of a large-cell non-Hodgkin's lymphoma in a patient suffering from chronic lymphocytic leukaemia is known as Richter's syndrome, representing one of the possible anaplastic transformations of the leukaemia. Cutaneous involvement is an extremely rare event. The case of a 45-year-old man with B-cell chronic lymphocytic leukaemia is reported. Five years later multiple cutaneous nodules developed on his extremities. Biopsies of the skin showed a diffuse large-cell lymphoma, bearing the same cell surface immunoglobulin light chain isotype as the leukaemia, suggesting the original relationship between both neoplasms.

Adult↗
PubMed1992

[Splenic lymphangiomatosis].

Cystic lymphangiomatosis confined to the spleen is a very rare condition. This article describes one new case and briefly reviews the literature, while providing information of wider relevance.

Aged↗
PubMed1982

[Fazadinium in surgery of the gallbladder and the bile ducts].

The authors show their experience with fazadinium in the surgery of gall-bladder and biliary tract, and express an opinion of pleasured consideration about the practical effects of this drug, also deriving from the checking of the patients through the cardiovascular monitoring and pre- and postoperative hematochemical tests.

Adult↗