Biomedical subjects
Publications and source records attributed to A Rosa.
In absence of marked benign prostatic hyperplasia, alternative surgical procedure, the transurethral incision of the prostate (TUIP), is available. The Authors report their experience and suggest a comparison between the morphological data obtained with ultrasound and the functional data obtained with the uroflowmetry.
A spiral urethral prosthesis was inserted with use of local anesthesia in 5 patients with benign prostatic hyperplasia and 2 patients with cancer of the prostate, using ultrasonic guidance. All the patients refused the surgical procedure of had high operative risk. The Authors showed the usefulness of the Ultrasound for insertion of intraprostatic spiral, in selected patients.
The complications of endotracheal intubation are particularly frequent in patients with obstructive sleep apnoea syndrome (OSAS). We prospectively tested nasal ventilation in such patients admitted for acute respiratory failure. Six consecutive patients, aged 17-70 yrs, were selected for the study. All patients were confused or severely obtunded, Glasgow Coma Score (GCS) 10 (SD 2). With nasal bi-level positive airways pressure (BiPAP) all these patients improved clinical status and arterial blood gas values, avoiding intubation and invasive mechanical ventilation. The median pH increased from 7.26 (SD 0.06) to 7.36 (0.01) and to 7.43 (0.02) after, 1-3 and 24 h of nasal ventilation, respectively. Nasal ventilation lasted an average of 21 (3) h on the first day. All patients were discharged home after a median hospital stay of 28 (11) days.
The above study was aimed at evaluating the "in-hospital precoronary times" of patients with acute myocardial infarction presenting to the Emergency Department of Policlinico Umberto I, Rome. From April to August 1993, 58 cases of acute myocardial infarction were admitted. In six of these, over 24 hrs had elapsed before admission. In 24 of the remaining cases thrombolysis was indicated. Mean time before admission to the coronary unit was 5 hrs for 52 patients. Mean in-hospital delay before starting thrombolysis was 40 +/- 20 minutes; mean delay before admission to the coronary unit was 3 h/45 min. In-hospital time before thrombolysis was one of the lowest in the literature and shows the efficient organization of the department. Delay until transfer to the coronary unit was long and is a sign of the paucity of these specialized beds. Therefore, the possibility to perform thrombolytic therapy immediately in the emergency department becomes even more essential.
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The Authors report their experience in treatment of renal cysts by PCN ultrasound puncture: An aspiration technique is described. A sclerosing substance (sterile Alcohol 95%) has been injected into the cysts to prevent relapse by a pigtail catheter. Immediate and late results are discussed. The data obtained confirm this practice as the best choice in the treatment of this pathology.
The rare lesions of internal carotid arteries are varied in both their appearance and their cause. Schematically, in addition to congenital anomalies, of which fibromuscular dysplasia is no doubt the most frequent, should be noted lesions of inflammatory, infectious, traumatic and iatrogenic origin. The fact that the relationship between some of these lesions and cerebral vascular accidents is not clearly established, leads to diagnostic and therapeutic problems which are difficult to resolve.
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Among psychiatric entities, dysthymic patients provide a good model for studies on minor disturbances in sleep organization because they present borderline abnormalities in their night sleep that concern mainly slow wave sleep. A study on sleep phasic events was performed to evaluate abnormalities in sleep microstructure. Therefore, for all subjects--normal controls and dysthymic patients--the following phasic activities were scored: K-complexes, vertex sharp transients, posterior occipital transients, delta paroxysms, theta bursts, microarousals, and awakenings. Furthermore, other sleep EEG patterns, such as REM with spindles, and intermediate stages, were assessed. The following results were obtained: 1) dysthymic patients have less K-complexes and vertex sharp transients, with lower densities of these events; 2) they have a reduced number of microarousals, with an increased rate of awakenings; 3) patients present a higher incidence of other events such as theta bursts, POSTs, REM with spindles, and intermediate stages. These results suggest that the analysis of phasic events is useful for the discrimination between normal and pathologic sleep, even when there are only minor differences in terms of macrostructure.
Twenty male patients with known urethral stricture disease were evaluated using Ultrasonic urethrography, retrograde and anterograde urethrography and Cystoscopy for comparative analysis of the three techniques. The Ultrasonic urethrography provides the most accurate information regarding anatomic side, stricture length, number, the degree of scarring spongiofibrosis. Therefore the Authors suggest a larger use of this technique.
The Authors, observing two cases of penile cancer, lay stress on the role of Ultrasonography in this disease. Its easy and quick execution, its low cost, the possibility to repeat it, its diagnostic sensibility in evaluating the extent of the penile cancer, permit us to consider it a screening technique of primary importance.
We report two cases of Marchiafava-Bignami disease studied by CT and MR imaging. Both had hemispheric disconnection syndrome and favorable outcome. The only residual signs were agraphia with the left hand in the two cases and mild dementia in one. In one case, a control CT scan performed 3 weeks after the first one was normal whereas T2-weighted MR images showed high intensity signal in the corpus callosum. We conclude that: 1. there are benign forms of MB disease; 2. neuroimaging has diagnostic and prognostic value; 3. vitamin B deficiency may play a role in the pathogenesis of the disease.
Since the advent of arterial surgery, four decades of development have evolved, characterized not only by a remarkable evolution of concepts, but also by the improvement of technics, means and methods utilized for arterial reconstructive surgery. This progress led to the promotion and improvement of the conventional surgical methods dedicated to the treatment of the most common aortic disorders, obstructive or aneurysmal. Endarterectomy, revascularization using synthetic bypasses or interposition of arterial prosthesis are the most common and standardized procedures which are used worldwide, giving gratifying and long lasting results, involving low or negligible risks. In clinical practice however one sometimes, faces rare conditions, poorly understood due to their rarity, in which the conventional methods may be regarded as inappropriate, unfit or even formally contraindicated. Some unusual or uncommon methods were devised to deal with such conditions, which are less popular due to their rarity, but may also be considered just as valid and reliable as conventional methods, bearing satisfactory and rewarding results. Among them we stress the bypass originated in the ascending aorta, the bypass from the descending thoracic aorta and the bypass arising from the supraceliac aorta. The main features of these procedures as well as the personal experience of their utilization obtained by the senior author constitute the essence of this presentation.
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The authors examine the most recent findings on arterial hypertension with particular emphasis to morphological changes of the arterial wall and to the results of nicardipine treatment in spontaneous hypertensive rats (SHR). According to these assumptions the authors evaluate the effects of nicardipine on the microvascular network by means of a funduscopic examination in 8 hypertensive patients. The preliminary data suggest that nicardipine has a positive structural and morphological effect on the vessel network.
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We present an original case of Marchiafava-Bignami disease in a 47-year-old left-handed alcoholic man. Computed tomography and magnetic resonance imaging demonstrated the typical lesion, a necrosis of the middle portion of the corpus callosum. Diagnosis may thus be established in the living. In our case, the course was not fatal, which, to our knowledge, has only been described in four other cases in the literature. Clinically, our patient demonstrated an interhemispheric disconnection syndrome. The striking feature is that some of the symptoms were on the side opposite of the one that has previously been described in the literature, eg, right-handed agraphia, while others were on the usual side, eg, left-handed anomia. We discuss cerebral dominance for speech and handedness in left-handers and come to the conclusion that our patient's clinical features can only be explained by right hemispheric dominance for handedness and bilateral hemispheric representation of speech.
Conformational energy computations on Ac-L-(alpha Me)Val-NHMe indicate that turns and right-handed helical structures are particularly stable conformations for this chiral C alpha-methyl, C alpha-alkylglycyl residue. We have synthesized and characterized a variety of L-(alpha Me)Val derivatives and peptides (to the pentamer level). The results of the solution conformational analysis, performed using infrared absorption, 1H nuclear magnetic resonance, and circular dichroism, are in general agreement with those obtained from the theoretical investigation, in the sense that the L-(alpha Me)Val residue turns out to be a strong beta-turn and right-handed helix former. A comparison is also made with the conclusions extracted from published work on peptides rich in other C alpha-methyl, C alpha-alkylglycyl residues.