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Biomedical subjects

A Rotondo

Publications and source records attributed to A Rotondo.

115 records · Page 7Linked to original sources
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[Functional ano-rectal disorders: associated defecographic findings and related symptoms].

We retrospectively analyzed our latest 564 defecographies to evaluate: the frequency of each single defecographic finding on the total number of patients and in the two sexes; the frequency of the finding as single disorder and in association with other anorectal disorders; the correlation between findings and symptoms. The most common disorders were anterior rectocele (54%), mucosal prolapse (53%), puborectalis muscle syndrome (15%), and intussusception (15%); this order is respected in women (70, 57, 17 and 16% of the study population) but differs in men (mucosal prolapse 42%, puborectalis muscle syndrome 18%, posterior rectocele 14%, and intussusception 14%). Intussusception and puborectalis muscle syndrome were identified as an isolated finding in many cases (55% and 43%, respectively). The most common associations are: posterior rectocele with anterior rectocele (58% of cases), anterior rectocele with mucosal prolapse and vice versa (63% and 64%), intussusception with anterior rectocele (52%), puborectalis muscle syndrome with mucosal prolapse (36%) and with anterior rectocele (49%) and descending perineum syndrome with anterior rectocele (81%) and with mucosal prolapse (70%). The low rate of association among some disorders should be mentioned too for example, mucosal prolapse is associated, with intussusception only in 10% of cases. Clinical-defecographic correlations are less apparent: if some symptoms are found to be more typical of some disorders, this correlation is not pathognomonic and the clinical picture is quite aspecific. We stress the value of a careful correlation between clinical-anamnestic and defecographic findings for the correct evaluation of these disorders.

Adult↗
PubMedDate not supplied

[Computed tomography and magnetic resonance in the follow-up to interventions for the prosthetic replacement of the carpal bones].

The authors examined with CT and MRI 12 patients submitted to prosthetic replacement of necrotic carpal bones--7 of them because of scaphoid proximal pole posttraumatic osteonecrosis and 5 because of lunate Kienböck's disease. The prosthetic implants were autologous in all patients: they were taken from palmaris gracilis tendon and modified to give them a rounded shape, to adapt them to the new anatomic site. All patients exhibited postoperative limitation in flexion-extension movements; 5 of them reported associated wrist pain. The authors investigated the anatomic reasons of the postoperative symptoms and tried to assess CT and MR diagnostic capabilities in depicting these conditions. CT was performed with thin sections (1.5 mm) and multiplanar reconstructions, with a Philips Tomoscan LX unit. MRI was performed with a GE MR Max Plus unit at 0.5 T and a Medical Advances transmit-receiving extremity coil, on the axial, coronal and sagittal planes, with T1- and T2-weighted sequences. All patients had been submitted to conventional radiography of the wrist. In 6 patients CT and MRI showed severe synovial reaction in the surgical site, with new ligament absorption in 5 of them. In 5 of these patients CT identified some nodular calcifications, while MRI better depicted the fibrotic portion, if present. MRI demonstrated the carpal dorsal intercalated instability which was present in all the patients submitted to scaphoid proximal pole resection; in the patients operated on for Kienböck's disease, volar tilt of the scaphoid was increased. Both kinds of carpal instability were correlated with scaphoid-lunate surgical dissociation. These instabilities were greatly correlated with the postoperative symptoms. Currently, MRI is the gold standard in studying carpal instability and it is therefore fundamental in investigating the complex anatomic and biomechanical features of these patients postoperatively.

Carpal Bones↗
PubMedDate not supplied

[Hand injuries due to fireworks explosion].

Two different series of patients with burst injuries of the hand were retrospectively reviewed: one series included 23 men, 15-55 years old, referred to the emergency department for the first-instance assessment of injuries of the right hand (13 patients) and left hand (10 patients). The other series included 44 patients (42 men and 2 women, aged 7-61 years) referred to our department for second-instance examinations: the latter patients had burst injuries involving only the hands in 43 cases and both the hand and the foot in one case. We report the radiologic patterns of traumatic bone injuries (fractures and amputations) and of musculotendinous and cutaneous injuries and discuss their mechanisms and pathogenesis. The two series were compared and the results follow: in both series the right hand was more frequently involved, metacarpal bones were most often fractured and phalanges most often amputated. In the first series, in the right hand the carpal bones were involved in one patient only, the 2nd and 3rd metacarpal bones were most frequently fractured and the 2nd finger was most frequently involved. In the left hand, the carpal bones were never affected, the 1st metacarpal bone was most often amputated and the 5th metacarpal bone most often fractured; the 2nd finger was most frequently involved. In the second series, in the right hand, the 1st metacarpal bone was most frequently fractured and the 2nd metacarpal bone most often amputated; the 2nd finger was most frequently involved. In the left hand, the 4th metacarpal bone was most frequently fractured and the 5th metacarpal bone most often amputated. The severity of the above injuries and the extent of tissue damage depend on several factors, including firecracker speed, shape, size, weight and characteristics. Radiologic exams are very useful for the accurate study of these traumatic injuries, providing indirect information about musculotendinous and cutaneous involvement. Prompted by the relative lack of information on the management of these injuries, we suggest that radiologic exams be quickly performed to help choose the most appropriate surgical approach for best cosmetic and functional results.

Adolescent↗
PubMedDate not supplied

[High resolution computerized tomography: dose evaluation with an anthropomorphic phantom].

High resolution Computed Tomography (HRCT), a technique for pulmonary parenchyma studies, has been for a long time performed with only few scans with a large interval in between: the reasons were the supposed increase in the dose to the patient after kVp and mAs increase, which is necessary to reduce background noise, and the characteristic distribution of most diffuse lung diseases. Of late, HRCT skin dose has been demonstrated to be markedly lower than that of conventional CT (8/10 mm contiguous slices). To evaluate organ doses to patients during HRCT, we compared conventional CT (10 mm slices), HRCT (1.5 mm slices) and chest X-ray doses, as measured on an anthropomorphous phantom. We tested several scan protocols, with different kVp and mAs values to simulate various clinical situations for the two techniques, always with both slice thickness values and both contiguous and non-contiguous (10 mm gap) slices for HRCT scans. Doses were substantially similar for the two methods with contiguous slices in every protocol. "Clinical" HRCT dose (non-contiguous slices with 10 mm gap) is much lower than that of conventional CT--i.e., about 13% of conventional CT dose. On the other hand, HRCT dose is still two orders of quantity higher than that of standard radiography. To conclude, the importance of HRCT in pulmonary parenchyma studies is confirmed.

Models, Biological↗