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Biomedical subjects

A Fantini

Publications and source records attributed to A Fantini.

At least 37 records · Page 2Linked to original sources
PubMed1993

Quantitative evaluation of left ventricular shape in anterior aneurysm.

The purpose of the study was to analyze left ventricular (LV) shape in post-infarction anterior aneurysm by utilizing quantitative analysis of wall curvature. Forty-one patients (39 men, 2 women; mean age 56 years) subjected to surgical intervention for LV aneurysm complicating an anterior myocardial infarct were retrospectively evaluated. In all patients the presence of resectable aneurysmal tissue had been confirmed by direct surgical examination. Patients with inferior myocardial infarction and patients who had undergone percutaneous transluminal coronary angioplasty (PTCA) or bypass surgery were excluded. Pre-intervention ventriculograms (RAO projection) were analyzed. LV wall excluded. Pre-intervention ventriculograms (RAO projection) were analyzed. LV wall motion was studied by applying the centerline method. Regional curvature of end-diastolic and end-systolic outlines was calculated at 90 equidistant points from aortic corner (point 1) to mitral plane (point 90). Patients with LV anterior aneurysm show a typical pattern of alterations in wall curvature, which is characterized by a shifting of the angiographic apex (the point with the greatest curvature) towards the mitral plane, and by a sharp shift of curvature values at the antero-basal and infero-apical regions, marking the borders of the sac. These hinge points closely correspond to the external limits of wall motion abnormalities. Significant correlations were found between degree of regional curvature alterations and severity of global LV dysfunction, as indicated by decrease of ejection fraction and increase of end-systolic volume. In conclusion, quantitative evaluation of LV shape by means of wall curvature analysis allows recognition of the characteristic morphologic changes of the aneurysm, i.e., wall expansion and deformation.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗
PubMed1993

Left ventricular remodeling in chronic aortic regurgitation.

Left ventricular (LV) shape in chronic volume overload due to aortic regurgitation is commonly described as rounder than in normal subjects. This statement derives from observations of qualitative nature or based on the measure of eccentricity index. We analyzed LV shape and function in 16 normal subjects (N) and in 24 patients with chronic pure aortic regurgitation (AR), without coronary artery disease or associated mitral regurgitation. LV cavity geometry was quantitatively evaluated from end-diastolic and end-systolic outlines obtained in 30 degrees RAO angiographic projection, by calculating: 1. the eccentricity and circularity indexes, 2. the regional curvature at 90 equidistant points using a windowed Fourier series approximation of contours, in which the number of harmonics and filter-window were locally chosen in order to minimize the reconstruction errors and to maximize the smoothness of the curve, 3. by measuring the length of the anterior and posterior hemi-perimeter of LV outlines and 4. by performing a Fourier analysis of LV contours. Neither eccentricity nor circularity indexes were adequate to differentiate shape abnormalities, whereas Fourier geometric analysis indicated abnormalities of shape in AR. Regional curvature showed that diastolic outline of AR had a greater curvature of the anterobasal, anterolateral and inferoapical regions and a lower curvature of the anteroapical one. Systolic outline showed a greater curvature of the inferoapical region and a lower curvature of the anteroapical one.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Risk stratification in patients with a first myocardial infarct based on simple clinico-instrumental variables].

UNLABELLED: It is an acknowledged fact that the prognosis for patients with a first myocardial infarction depends mainly on the degree of residual left ventricle function. We wanted to evaluate the importance that certain simple clinical and instrumental variables can have in stratifying post-infarction cardiovascular risk with particular emphasis on chronic obstructive lung disease (COLD). We selected 97 out of the 512 patients treated in the coronary intensive care unit (CICU) from February 1, 1988 to October 31, 1990 according to the following criteria: First myocardial infarction; no cardiogenic shock; no serious concomitant diseases with considered negative prognosis within 6 months. The following variables were considered for all the patients: age; sex; positive family history for ischemic heart disease; history of diabetes mellitus; arterial hypertension; previous cerebrovascular incident; history of obstructive arteriopathy of the lower limbs, of angor and COLD. The following tests were performed on all the patients: echocardiogram prior to discharge form the CICU; angiocardioscintigraphy with Tc-99 between the 20th and 30th day following the acute event; bicycle ergometer stress test on the 30th day. END POINTS: general mortality; cardiac mortality; non-fatal reinfarction; residual angina at 3 months. All the patients were treated with aspirin (325 mg/die) and/or heparin (12,500 units subcutaneously). All 97 patients were monitored for a mean follow-up time of 19.8 months. General mortality was 2.08% (for reinfarction) 24 (24.7%) non-fatal cardiac events.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1992

[VIPoma: surgical treatment].

This paper reports a case of pancreatic VIPoma with widespread hepatic metastasis which was treated for approximately 2 years with a synthetic somatostatin analog (SMS 201/995). The treatment of choice in cases in which the tumour was fully removable is surgical resection. This occurred rarely since approximately 80% of VIPomas are malignant and are operated late when local infiltration is already widespread; in addition, 50% of cases are already metastasised at diagnosis. In this case, due to the infiltration of the superior mesenteric artery by the primary tumour it was necessary to carry out a left pancreasectomy which included two-thirds of the neoplastic mass. This was justified by slow tumour growth and also facilitated control of diarrhea and ensured a greater efficacy of possible postoperative chemotherapy. The use of synthetic somatostatin analog (SMS 201/995) enabled diarrhea to be satisfactorily controlled and is therefore specifically indicated for this type of tumour. NSE serum assay (neuron specific enolase) allowed the evolution of disease to be monitored during follow-up.

Female↗
PubMed1992

[Laparoscopic cholecystectomy: analysis of first 203 cases].

Laparoscopic cholecystectomy is a valid alternative to open cholecystectomy. The Authors present their experience in the management of 208 consecutive patients. The low incidence of complications, the short hospital stay as well as earlier return to work, and lower medical expenses are the advantages of laparoscopic surgery. The latter is, therefore, more suitable for the treatment of benign gallbladder diseases.

Cholecystectomy↗
PubMed1990

Abnormalities of left ventricular shape in patients with stable angina.

In this study, left ventricular shape was evaluated quantitatively by calculating the power spectrum and the regional curvatures of angiographic outlines as seen in the right oblique anterior projection. Two groups of patients were studied: 16 normal subjects and 16 patients with stable angina who were selected because of normal left ventricular function (normal left ventricular volumes, pressures, ejection fraction and no regional wall motion abnormality at subjective analysis of ventriculograms). The two groups did not differ in terms of mean age of the patients. Regional curvatures were calculated using the Frenet-Serret formula starting from the mitral corner (point 1) and extending to the aortic corner (point 90). The power spectrum was calculated by means of Fourier analysis. The ventricular shape during diastole of the patients with angina differed significantly from that of the normal group in that there was a greater posterobasal curvature; a lower curvature of the inferior wall showing an inward convexity; a greater parietal curvature of the inferoapical region and a minor curvature of the anterobasal region. The power spectrum differed significantly from that of the normal subjects. The 1st and 2nd harmonics were reduced and the 3rd, 4th, 5th and 6th ones increased. The end-systolic contour of the group of patients with stable angina showed a higher amplitude of the 3rd and 5th harmonics and a lower amplitude of the 1st, 2nd, 9th, 10th and 11th harmonics with respect to the group of normal patients. Regional curvatures showed significant differences between the two groups in the antero-basal region. These modifications of left ventricular shape in patients with stable angina did not appear to be related to age and/or heart rate; to abnormalities in hemodynamics and wall motion; or to acute ischemia. Abnormalities of shape in patients with stable angina, therefore, may indicate a remodeling of the left ventricle due to the structural effects (myocardial and/or interstitial) of chronic ischemia.

Adult↗
PubMed1990

[What happened to Zollinger-Ellison syndrome?].

Three Zollinger-Ellison syndrome patients were treated during the period January 1977 to June 1978. The first patient is in good health 11 years 3 months after a total gastrectomy as is the second patient, 11 year after the enucleation of a cephalo-pancreatic gastrinoma. However the third patient died from malignancy 5 years after a total gastrectomy and enucleation of a cephalo-pancreatic gastrinoma followed by therapeutic cycles with streptozotocin and 5-fluorouracil. The decline in the Zollinger-Ellison syndrome over the last ten years is examined and the type of surgical treatment is discussed. Total gastrectomy once advocated as the preferred treatment, is now reappraised because of the effectiveness of medical therapy in controlling ulcers and because of the frequent malignancy of pancreatic gastrinomas.

Adult↗
PubMed1989

[Echocardiographic study of the left ventricle function in heroin dependence].

The left ventricular function has been examined in 20 drug addicts with echo-Doppler and echocardiographic methods. The results obtained demonstrate that, in a certain percentage of drug addicts, there is, in comparison to controls, a subclinical alteration of the ejection fraction and the circumferential shortening velocity; on the contrary, alterations of cardiac output are not observed.

Adult↗
PubMed1989

[Spontaneous pneumothorax (therapeutic consideration)].

The Authors report the results achieved in 74 patients with spontaneous pneumothorax. The treatment was conservative in 66 patients. The surgical treatment was performed in 8 patients operated with monolateral resection of apical bullae (7 cases) or lobectomy (1 case) through lateral thoracotomy.

Adolescent↗
PubMed1989

[Analysis of the shape of the left ventricle by studying the regional curvature and power spectrum. I. Methodology and results in normal subjects].

Quantitative analysis of left ventricular shape, obtained by measuring the regional curvatures and power spectrum of the harmonics of left ventricular outlines, is a useful method that has seldom been used in clinical research because of the need for a reliable and replicable method. The curvature of each point of an outline is the reciprocal of the radius of the circle that best fits a segment of the arc (window) centred at any specified point. We proposed a method based on the rate of change of the tangent vector with respect to the change in arc length, normalized for the width of the considered segment (Frenet-Serret formula). The series of curvature values allows us to obtain the power spectrum by means of Fourier analysis. The application of the method to a series of ellipses with variable eccentricity and size demonstrated that the width of the window is critical in the circulation of the curvature, and the choice of the number of points for computing has to be optimized to obtain the best signal-noise ratio. The method, applied using a sampling every 0.1 mm and optimized using a window of 25 points in the experimental model, is independent of the size of the samples, is able to distinguish small variations of eccentricity and to separate the signal from the noise due to digitizing and computing up to the 12th harmonic. The method has been applied to the left ventricular outlines of 16 subjects without any cardiac abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗
PubMed1989

[Analysis of the shape of the left ventricle by studying the regional curvature and power spectrum. II. Morphologic changes in post-infarction ischemic heart disease].

The quantitative analysis of left ventricular shape in ischaemic heart disease has seldom been performed because of the lack of a reliable and reproducible method of analysis. Diastolic and systolic left ventricular outlines in two groups of patients with previous myocardial infarction (anterior in 13 cases and inferior in 14 cases) were studied by analyzing the regional curvature and the power spectrum. This method allowed us to obtain left ventricular curvatures from the mitral to the aortic corner and the power spectrum of the first 12 harmonics. The results obtained in these two groups were compared with those obtained in 16 normal subjects. The diastolic power spectrum in both infarcted groups was similar. It was characterized by a double peak which was different from that of the normal subjects. Slight differences between the two infarcted groups were due to the diverse amplitude of the highest harmonics. The regional analysis of the curvature in both groups showed similar abnormalities of the posterobasal, inferior and antero-basal regions. The posterior wall showed a uniform curvature with the point of minimum shifted towards the mitral corner; the anterior wall showed a rounded profile with a regular curvature. In the group with anterior myocardial infarction the curvature of the inferior wall was negative, i.e., convex towards the left ventricular cavity. The systolic power spectrum showed a double peak profile which was different from that of the normal subjects. There were some differences between the two groups as regards the first and the highest degree harmonics. In inferior myocardial infarction the apex was rounded whereas in the anterior one the most important abnormalities were the convexity of the inferior wall towards the inside and the presence of a region with minor curvature between two regions with greater curvature of the anterior wall. Some of the systolic abnormalities involved the probable site of the infarct while others were in remote regions. The meaning of remote abnormalities is not clear. However, we did not verify a correlation between wall motion, at least as shortening of radii, and regional curvature. The abnormalities of the diastolic outline were independent of the site of the infarct and did not appear to be correlated to end-diastolic pressure or to the ejection fraction. They seemed to be the morphological counterpart of the filling abnormalities reported in ischaemic cardiac disease and they may depend on the regional distribution of stresses.

Cineradiography↗