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Biomedical subjects

A Mancuso

Publications and source records attributed to A Mancuso.

At least 73 records · Page 4Linked to original sources

Inferior rectus muscle contracture syndrome after retrobulbar anesthesia.

Ipsilateral hypotropia with restricted elevation is an increasingly recognized strabismic entity resulting from injury to the inferior rectus muscle after local retrobulbar anesthesia. Eight patients with this disorder are described. Computed tomography of the orbit in three patients demonstrated isolated segmental enlargement of the retrobulbar portion of the inferior rectus muscle; the findings of magnetic resonance imaging in one patient was most compatible with fibrosis. Four patients underwent strabismus surgery consisting of adjustable recession of the affected inferior rectus muscle; all recovered single binocular vision in the functional fields of gaze postoperatively. Surgical exploration of the ipsilateral inferior rectus muscle demonstrated normal anatomy in the peribulbar portion of the muscle.

Aged↗

The abraded punch graft for pitted facial scars.

The abraded punch graft procedure is one in which the surrounding scar area and the graft itself are superficially dermabraded before correction of the defect. This alternative procedure has distinct advantages over the standard punch graft and should be considered when contemplating the surgical correction of "ice pick" facial scarring. Following the normal reparative process, the abraded punch graft heals with a pleasing aesthetic appearance.

Acne Vulgaris↗

Radiation-induced optic neuropathy: a magnetic resonance imaging study.

Optic neuropathy induced by radiation is an infrequent cause of delayed visual loss that may at times be difficult to differentiate from compression of the visual pathways by recurrent neoplasm. The authors describe six patients with this disorder who experienced loss of vision 6 to 36 months after neurological surgery and radiation therapy. Of the six patients in the series, two had a pituitary adenoma and one each had a metastatic melanoma, multiple myeloma, craniopharyngioma, and lymphoepithelioma. Visual acuity in the affected eyes ranged from 20/25 to no light perception. Magnetic resonance (MR) imaging showed sellar and parasellar recurrence of both pituitary adenomas, but the intrinsic lesions of the optic nerves and optic chiasm induced by radiation were enhanced after gadolinium-diethylenetriaminepenta-acetic acid (DTPA) administration and were clearly distinguishable from the suprasellar compression of tumor. Repeated MR imaging showed spontaneous resolution of gadolinium-DTPA enhancement of the optic nerve in a patient who was initially suspected of harboring recurrence of a metastatic malignant melanoma as the cause of visual loss. The authors found the presumptive diagnosis of radiation-induced optic neuropathy facilitated by MR imaging with gadolinium-DTPA. This neuro-imaging procedure may help avert exploratory surgery in some patients with recurrent neoplasm in whom the etiology of visual loss is uncertain.

Aged↗

The residual ovary after hysterectomy.

Of 118 cases of patient who had undergone abdominal hysterectomy with the preservation of one or both the ovaries, only 73 patients (62%) attended for review. Eleven had had cysts of the residual ovary. The occurrence of an asymptomatic pathology in three cases suggest that patients, for whom preservation of an ovary was considered preferable, should undergo a periodic clinical and ultrasonographic review.

Adult↗

[Analysis of factors associated with very low birth weight (less than or equal to 1500 g)].

In 7675 deliveries performed at the University of Messina between November 1, 1983 and October 31, 1988 we determined the incidence and obstetric factors specifically associated with the birth of very low weight infants (less than or equal to 1500 gm) (VLBW). Our purpose was to characterize these factors in order to determine what may be done to limit delivery rate of VLBW. Information obtained concerning the mothers' included socioeconomic status, age, parity, previous obstetric history, any maternal conditions affecting the pregnancy, route of delivery (vaginal or operative). The incidence of infants under 1500 gm was 1.1 per cent of live births. The etiologic analysis showed that preterm labor is more frequent cause of VLBW. In women under 17 years of age the incidence of VLBW was 5.2 per cent as opposed to 1.1 per cent in the total population. Absence of prenatal care was shown in 40.8 per cent of VLBW. The previous obstetric history reported 1 or more abortions in the 53 per cent and 1 or more perinatal deaths in 17 per cent of VLBW. The clinical implications of these results are discussed.

Humans↗

Gadolinium-DTPA-enhanced magnetic resonance imaging in experimental optic neuritis.

Magnetic resonance imaging (MRI) with gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) was used to investigate disruption of the blood-optic nerve barrier associated with acute autoimmune demyelination. Leakage of Gd-DTPA was seen in the optic nerves and optic chiasm of adult guinea pigs sensitized for acute experimental allergic encephalomyelitis, but not in normal unsensitized animals. This finding occurred as early as 5 to 8 days after antigenic sensitization with the myelin emulsion and before the onset of paralysis or ataxia. Pathologic examination at this early stage of experimental allergic encephalomyelitis showed an absence of demyelination in the optic nerves and optic chiasm, although scant perivascular foci of inflammatory cells were seen. Leakage of Gd-DTPA in the optic nerve before demyelination of this white matter tract illustrates that increased permeability of the blood-optic nerve barrier is an early, if not the initial, event in autoimmune demyelination, and the optic nerve is a common site of central nervous system involvement during the initial phase of acute experimental allergic encephalomyelitis. Findings in this animal model appear comparable with the results of MRI with Gd-DTPA in patients with optic neuritis, and they suggest that disruption of the blood-optic nerve barrier is a common denominator for both disorders of primary demyelination.

Animals↗

A nuclear magnetic resonance technique for determining hybridoma cell concentration in hollow fiber bioreactors.

We have developed a technique for determining cell concentration in a hollow fiber bioreactor based on 23Na nuclear magnetic resonance (NMR) spectroscopy. Cell concentrations determined with this method agreed closely with concentrations calculated from 31P NMR nucleoside triphosphate (NTP) measurements and oxygen consumption rate measurements. Oxygen transfer limitations, which can complicate cell mass determinations based on oxygen consumption rates, were shown to be negligible for the bioreactor used. Specific antibody production rates in hollow fiber culture, calculated from these cell number estimates, were similar to those found in suspension culture for this cell line.

Animals↗

Transient acantholytic dermatosis treated with isotretinoin.

Transient acantholytic dermatosis is a self-limiting benign disease. It is characterized by multiple pruritic erythematous papules and papulovesicles found predominantly on the trunk and extremities. This primary acantholytic dermatosis affects individuals older than 40 years. We present a case study of an individual who received a regimen of isotretinoin (Accutane) for treatment of severe pruritus after conventional forms of therapy failed to alleviate his condition and abate the formation of new lesions.

Epidermolysis Bullosa↗

Gadolinium-DTPA-enhanced magnetic resonance imaging in optic neuropathies.

Magnetic resonance imaging (MRI), after intravenous administration of the paramagnetic agent gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA), showed enhancement of the optic nerve in 7 of 13 patients with acute optic neuritis. Four of these patients had Gd-DTPA enhancement of the intracranial optic nerve and two had involvement of the optic nerve at the orbital apex, ipsilateral to the eye with visual loss. Gadolinium-DTPA enhancement of both intracranial optic nerves was seen in one of two patients with bilateral retrobulbar neuritis. Two patients with acute radiation-induced optic neuropathy also had Gd-DTPA enhancement of the intracranial optic nerve. The authors recommend MRI with Gd-DTPA as the neuro-diagnostic procedure of choice for visualization of increased permeability of the blood-brain barrier in acute optic neuritis and radiation-induced optic neuropathy.

Adolescent↗

Measurement of pharyngeal volume by digitized magnetic resonance imaging. Effect of nasal continuous positive airway pressure.

Pharyngeal size is thought to play an important role in the pathogenesis of snoring and obstructive sleep apnea. It has been hypothesized that nasal continuous positive airway pressure (CPAP) works by enlarging pharyngeal size and splinting the airway open. In this study, we selected 12 heavy snorers and abolished their snoring with nasal CPAP in our sleep laboratory. Using magnetic resonance imaging and a computer program utilizing a digitizing pad, we measured these awake subjects' pharyngeal volumes without and with the nasal CPAP apparatus on at the level used to abolish their snoring. We found an average 27.7% increase in pharyngeal volume with nasal CPAP. We have visually shown an increase in pharyngeal size with the use of nasal CPAP in a cohort of heavy snorers.

Adult↗

Multicenter double-blind placebo-controlled study of gadopentetate dimeglumine as an MR contrast agent: evaluation in patients with cerebral lesions.

A multicenter double-blind randomized study was designed to evaluate and compare the safety and diagnostic efficacy of gadopentetate dimeglumine (Gd-DTPA) (0.1 mmol/kg) against a saline placebo for use as an IV contrast agent for MR. The randomization code provided for a 2:1 ratio of Gd-DTPA and saline patients. Six investigators studied 88 patients with signs and symptoms of a cerebral lesion. Although safety data were complete in all 88 cases, only 83 had valid efficacy data (57 received Gd-DTPA, 26 placebo). Three patients were excluded from efficacy evaluation because of incomplete scans or scans with severe motion artifacts. Two patients were excluded for protocol variations (did not have a mass lesion). The protocol required that spin-echo MR images be acquired both before and after infusion at mode 1, 500/30/2 (TR/TE/excitations), and at a single-echo mode 2 sequence within a selected range, 1500-2000/56-90/2. Additional TEs could also be used at the discretion of each investigator. Efficacy was determined by comparing post- with preinjection images for relative degree of enhancement and improvement of diagnostic ability after injection, and by comparing these results with placebo results. Enhancement was reported in 43 (75%) of 57 Gd-DTPA patients and in none of the 26 placebo patients. Improvement of diagnostic ability was noted in 37 of 57 Gd-DTPA patients and in no placebo patients. Of 17 patients receiving Gd-DTPA for whom no diagnosis could be made before infusion, nine of 17 were diagnosed after infusion. By comparison, none of five patients not diagnosed before infusion of placebo could be diagnosed after infusion. Of 43 patients in whom lesion enhancement was observed after Gd-DTPA infusion, the diagnosis changed after infusion in 16 (37%) and the number of lesions detected after infusion increased in 10 (23%). Safety studies showed no clinically significant abnormal trends. Minor changes in blood pressure, pulse, and serum iron levels were noted in a higher percentage of Gd-DTPA patients. This study confirms that Gd-DTPA is an efficacious contrast agent for use with MR and that it exhibits excellent patient tolerance. Enhancement allows for a decisive diagnosis to be made in selected cases in which such capability had previously been lacking with unenhanced MR.

Adolescent↗

[Beta-mimetic tocolysis: maternal and fetal side-effects].

The literature on materno-foetal effects of the administration of beta-mimetic tocolytics has been examined. Data and series observed show a certain number of unwanted maternal and foetal effects of a metabolic and cardiocirculatory nature. Although these are usually reversible, they may, in conditions of latent pathology, turn into serious accidents. Critical evaluation of research carried out makes it possible to reiterate the usefulness of these drugs, always providing that the absolute need to use them can be demonstrated, and that their use is preceded by careful evaluation of the patient's cardiocirculatory and metabolic condition.

Female↗

[Alcohol withdrawal syndrome. Effects of short-term treatment with dapiprazole].

A study on dapiprazole, a new psychotropic agent, in the treatment of patients during the alcohol withdrawal syndrome, is reported. On the basis of evaluations made on the severity of the physical and psychic symptoms of withdrawal, the conclusion is drawn that the new psychotropic agent, administered at gradually increasing doses of 40 to 90 mg/kg for 7 days, completely controls the clinical symptomatology at least in 70% of the cases treated.

Adult↗

Risk factors of endometrial cancer in Palermo.

A case-control study on 150 cases and 300 non-neoplastic controls admitted to the Obstetric and Gynaecologic Clinic B of the University of Palermo from 1977 to 1986 was carried out in order to assess the risk factors of corpus uteri cancer in Palermo area. Age at menarche less than 11, menopausal status, nulliparity, diabetes and obesity were found significantly associated with the risk of cancer; family history of neoplastic disease was slightly under statistical significance. It can be concluded that the same etiologic factors of endometrial cancer, as in other areas, may be operating in Palermo women.

Adult↗