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Biomedical subjects

A Gentili

Publications and source records attributed to A Gentili.

At least 55 records · Page 3Linked to original sources
PubMed1996

Lateral down-sloping of the acromion: a useful MR sign?

OBJECTIVE: The anterior acromion may appear to slope downward in a lateral direction on coronal-oblique magnetic resonance (MR) images of the shoulder. We sought to determine the significance of this finding as a marker of rotator cuff impingement. PATIENTS AND METHODS: MR studies of 58 subjects (26 with impingement, 32 with glenohumeral instability) were retrospectively analysed. Subjective down-sloping of the acromion was compared to standardized acromial measurements made on MR (acromial axis, width of the anterior acromion, and distance of the acromioclavicular joint from the superior glenoid) and clinical diagnosis. RESULTS: Interobserver variance for lateral down-sloping was fair (kappa = 0.5). One reader's assessment of lateral down-sloping of the acromion correlated with standardized MR measurements. Subjective lateral down-sloping of the acromion did not, however, correlate with impingement. CONCLUSION: The subjective finding of a laterally down-sloping acromion on coronal-oblique MR images, while partially validated by standardized measurements, is not predictive of impingement syndrome.

Acromion↗
PubMed1996

Pictorial review: foot axes and angles.

Using radiographs and diagrams, this article reviews the most commonly used axes and angles of the foot, including: longitudinal axis of the rearfoot, collum tali axis, talocalcaneal angle, cuboid abduction angle, longitudinal axis of the lesser tarsus, lesser tarsus angle, talonavicular angle, longitudinal axis of the metatarsus, forefoot adductus angle, metatarsus adductus angle, first intermetatarsal angle, hallux valgus angle, proximal and distal articular set angles, and hallux interphalangeal angle, plane of support, collum tali axis, talar declination angle, calcaneal inclination axis, lateral talocalcaneal angle, first metatarsal declination axis and calcaneal inclination angle.

Foot↗
PubMed1996

Quality of life in patients using self-administered intracavernous injections of prostaglandin E1 for erectile dysfunction.

PURPOSE: We assessed changes in quality of life after 6 months of self-injections of prostaglandin E1 for the treatment of erectile dysfunction. MATERIALS AND METHODS: A prospective study was done at a university affiliated Veterans Affairs medical center of patients using prostaglandin E1 at home. Quality of life was assessed with the Case Western Reserve University sexual functioning questionnaire and the Duke health profile. These questionnaires were administered before initiation and after 6 months of prostaglandin E1 therapy. RESULTS: Of 16 subjects injecting prostaglandin E1 at home 15 completed 6 months of therapy, and 13 of them completed both questionnaires. While using prostaglandin E1 we found an increase in the frequency of sexual activity from 2.9 to 5.5 times during the prior month (p = 0.01), rigidity of erection scores from 3.8 to 7.6 (p = 0.002, score 0-no erection to 8-full erection) and sexual satisfaction scores from 2.5 to 4.1 (p = 0.03, score 0-extremely unsatisfied to 5-extremely satisfied). We also found improvements in mental health scores from 80.0 to 92.3 (p = 0.007), social health scores from 61.5 to 80.8 (p = 0.004) and self-esteem scores from 72.3 to 86.9 (p = 0.01) on a scale of 0 to 100, where a higher score indicates better health. CONCLUSIONS: Self-injection of prostaglandin E1 improves sexual satisfaction and quality of life in men with erectile dysfunction.

Adult↗
PubMed1996

MRI and morphology of the insertion of the patellar tendon after graft harvesting.

We performed MRI on 16 patients who had had reconstruction of the anterior cruciate ligament (ACL) with a mid-third bone-patellar-tendon-bone autograft. Our aim was to assess the tendon and the site of its insertion at an average of seven years after the original operation. In four of these patients biopsies were taken from the donor site when they had revision of their original operation. MRI showed reconstitution of the tendon into the patellar defect with no evidence of bone formation. Six patients had a persistent defect in the patellar tendon itself. Histological examination of the biopsies of the donor site showed an indirect pattern of insertion with absence of the normal fibrocartilage zone. These morphological changes may adversely affect the biomechanical properties of the healed donor site and we suggest that another graft taken from this site may not be suitable for use in a further operation for reconstruction of the ACL.

Adult↗
PubMed1996

[Infusion constituents in pediatric anesthesia].

A suitable perioperative fluid therapy during paediatric anaesthesia presupposes a valuation of renal function and the preoperative fluid and electrolyte imbalance, a precise knowledge of fluid requirements and the physiological stress responses to surgery in different paediatric groups. Fluid administration must be suited to the pathology of the patients and surgical approach. It must replace the deficits from the preoperative status (including fasting), provide maintenance fluid and correct intraoperative translocated fluids and blood loss. Fluid management requires reduced hypotonic solution in order to prevent hyponatremia and avoid excessive amount of glucose which can be harmful. In order to prevent the dangers from blood transfusions you need to estimate the intraoperative loss and follow the "acceptable hematocrit" values. Rational intraoperative fluid management reduces perioperative morbidity and mortality.

Anesthesia↗
PubMed1995

Partial ACL rupture: an MR diagnosis?

PURPOSE: We sought to clarify the ability of magnetic resonance imaging (MR) to show partial anterior cruciate ligament (ACL) ruptures and to allow distinction of partial from complete ACL ruptures. MATERIALS AND METHODS: Eighty-eight patients were studied by arthroscopy and MR (36 with normal ACLs, 21 with partial ACL ruptures, and 31 with complete ACL ruptures). MR studies were interpreted by an experienced, blinded reader. MR examinations were also independently scored with respect to four primary and seven secondary signs, and these data were analyzed using discriminant analysis. RESULTS: The sensitivity of MR is lower for partial than for complete ACL ruptures. Most detected partial ACL ruptures resemble complete ruptures on MR. Secondary signs do not significantly improve detection of partial ACL ruptures, but they do help to distinguish partial from complete ACL ruptures. Displacement of the posterior horn of the lateral meniscus and popliteus muscle injury are indicative of complete ACL rupture. CONCLUSIONS: The majority of partial ACL ruptures are shown by MR, but MR is less sensitive for partial than for complete ACL rupture. The distinction of partial from complete ACL rupture on MR examination, while problematic, is slightly improved by assessment of secondary signs.

Adult↗
PubMed1994

Review of some common artifacts in nuclear medicine.

In nuclear medicine, artifacts may simulate a pathologic process; their recognition is therefore necessary to avoid misdiagnosis. Artifacts may be divided into three groups: 1) camera dependent artifacts; 2) radiopharmaceutical dependent artifacts; and 3) patient-related artifacts. The authors present a variety of artifacts and discusses their possible prevention.

Artifacts↗
PubMed1994

Imaging of disseminated infection by a rare fungal pathogen, Fusarium.

Imaging findings from a single case of disseminated infection with Fusarium are presented. This common fungus has been reported as a rare pathogen to the immunocompromised. Disseminated foci were identified on a Tc-99m HMPAO labeled WBC study. Two foci were localized to the proximal tibia using MRI. In this case, imaging was more sensitive to the extent of disease than physical examination, and it also provided a more precise estimate of disease progression than clinical evaluation alone. Imaging offers potential to track regression and to identify early recurrence. This is especially valuable because infection with Fusarium tends to be indolent.

Adult↗
PubMed1994

Labrocapsular ligamentous complex of the shoulder: normal anatomy, anatomic variation, and pitfalls of MR imaging and MR arthrography.

Magnetic resonance (MR) imaging is a useful modality for evaluating the labrocapsular ligamentous complex (LCLC) of the shoulder. MR arthrography is an important and occasionally indispensable supplementary modality for accurate differentiation between normal and deranged glenohumeral joints. Because of the joint distention that occurs during MR arthrography, it is especially helpful in detecting subtle capsular derangement, as occurs in patients with atraumatic instability. Also, some of the pitfalls associated with MR imaging of the LCLC are less likely to occur with MR arthrography. Radiologists should look for several key abnormalities when evaluating MR images of the shoulder: an anterior or posterior Bankart lesion; a Hill-Sachs defect; a tear of the rotator cuff, glenoid labrum, or superior labrum-biceps tendon attachment; and loose bodies. Knowledge of normal anatomy, normal variations, and pitfalls in image interpretation related to evaluation of the LCLC will help the radiologist accurately detect debilitating derangements associated with glenohumeral instability.

Humans↗
PubMed1994

Anterior cruciate ligament tear: indirect signs at MR imaging.

PURPOSE: To establish the sensitivity and specificity of indirect signs at magnetic resonance (MR) imaging of anterior cruciate ligament (ACL) tear. MATERIALS AND METHODS: MR images of the knees of 89 consecutive patients (54 with torn and 35 with normal ACLs) were reviewed. RESULTS: The indirect signs were as follows (first percentage is sensitivity; the second, specificity): angle between lateral tibial plateau and ACL less than 45 degrees (90%, 97%); angle between Blumenstaat line and ACL more than 15 degrees (89%, 100%); bone contusions in lateral compartment (54%, 100%); position of posterior cruciate ligament (PCL) line (52%, 91%); PCL angle less than 107 degrees (52%, 94%); PCL bowing ratio more than 0.39 (34%, 100%); posterior displacement of lateral meniscus more than 3.5 mm (44%, 94%); anterior displacement of tibia more than 7 mm (41%, 91%); and lateral femoral sulcus deeper than 1.5 mm (19%, 100%). CONCLUSION: Because the specificity is high, the presence of indirect signs corroborates the diagnosis of ACL tear. Because the sensitivity is low, the absence of these signs does not exclude the diagnosis of ACL tear.

Adult↗
PubMed1994

Resection arthrodesis of the knee for tumor: large intercalary allograft and long intramedullary nail technique.

Twenty-five patients had a procedure consisting of resection of the distal femur or proximal tibia for aggressive or malignant neoplasms. The resulting bony gap was bridged by allografts averaging 18 cm in length. Fixation was achieved using a long fluted intramedullary nail. The average follow-up time and time to union were 3 years (range, 0.25 to 9 years) and 13 months (range, 6 to 28 months), respectively. Eleven patients had nononcologic complications related to the index surgical procedure, including two patients with allograft nonunion. There were no infections. Three patients had amputations for local recurrence of their tumor. Twenty patients (80%) had no evidence of tumor at the time of follow-up. According to the Evaluation System of the Musculoskeletal Tumor Society, 80% of patients had a satisfactory result. No patient had a nononcologic complication resulting in total failure or amputation. The procedure of resection-arthrodesis of the knee using a large allograft with a long intramedullary nail provides patients with a stable, durable biological reconstruction that allows early weight-bearing, and the procedure carries a low incidence of infection.

Adolescent↗
PubMed1994

Structural alterations of basal keratinocytes and capillary loop in psoriasis during treatment with topical calcipotriol.

Recent research has demonstrated the activity of calcipotriol, effective as a potent inhibitor of cellular proliferation and known to increase differentiation in a number of cell lines in the topical treatment of psoriasis. Vit D3 receptors are expressed in keratinocytes and vascular endothelial cells. We studied the alterations in basal keratinocytes (stem cells or anchoring cells) and endothelial cell modification in 6 patients with psoriasis treated with calcipotriol ointment twice a day for 4 weeks. The samples were embedded in Epon resin for thin section and ultrathin section examination by electron microscopy. A normal pattern of distribution of the two different types of basal keratinocytes was observed before treatment. After treatment, only anchoring cells were detected. The alterations of endothelial cells in capillary loop disappeared after treatment, presenting normal aspects. Our morphological findings suggest that calcipotriol is therapeutically effective, due principally to an inhibition of cellular proliferation.

Calcitriol↗
PubMed1993

Scintigraphic detection of bile leaks after laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is widely accepted as an alternative to traditional open cholecystectomy. Its advantages are a shorter hospital stay, earlier return to normal activity, less pain, and improved cosmetic results. However, in the initial experience with this technique, biliary leaks were several times more frequent than in traditional cholecystectomy. Four cases of scintigraphic detection of biliary leaks after laparoscopic cholecystectomy are described. The results of the examination are compared in two cases with endoscopic retrograde cholangiography and in the remaining two with intraoperative findings. Hepatobiliary scintigraphy is suggested for early evaluation of postoperative complications involving the biliary system.

Adult↗
PubMed1991

Incidental detection of urinary tract abnormalities with skeletal scintigraphy.

Urinary tract abnormalities are detected as incidental findings in 15% of skeletal scintigraphic studies. Several scintigraphic patterns denote these abnormalities. Bilateral diffuse increased uptake is found in patients who have undergone chemotherapy and those with hyperparathyroidism, hypercalcemia, and sickle cell disease. Bilateral diffuse decreased uptake occurs in patients with end-stage renal disease, extensive metastatic disease to the bone, and various hematologic disorders. Focal increased activity is associated with postoperative changes and effects from radiation therapy. Focal decreased uptake is caused by space-occupying lesions such as abscesses, cysts, and neoplasms. Abnormal size, shape, and position associated with abnormalities of the kidney and bladder can also be seen. Although these scintigraphic patterns are seldom suggestive of a definitive diagnosis, they are highly specific for urinary tract disease.

Bone and Bones↗