Biomedical subjects
Publications and source records attributed to A Volpe.
We discuss in this report the results and limits of MR imaging in the evaluation of non focal hepatic pathology. At present, MR imaging seems to be one of the most important diagnostic steps, in the study of widespread hepatic diseases.
In this study we evaluated the role of barium examinations and above all computed tomography and magnetic resonance imaging in the study of Crohn's disease. CT is most often requested for patients with suspected or known intraabdominal or pelvic abscesses. MR plays a very important role in the localization of perirectal and perianal abscesses.
Ultrasound, hysteroscopy and magnetic resonance imaging has been considerated to assess the loco-regional or extrapelvic extension of the endometrial carcinoma. Sonography has demonstrated a certain inaccuracy in predicting myometrial invasion or the involvement of the canal. Hysteroscopy allows us to characterize neoplasia and to assess its extension in the cervical canal. MR imaging is more helpful in the diagnosis of channel invasion. The assessment of ovarian metastasis requires ultrasonography or coronal planes RM imaging. As regards the involvement of the pelvic and extrapelvic lymph nodes MR is more accurate than ultrasound scan.
In this report we evaluated the indications, the results and limits of MR examination in the diagnosis of neoplastic diseases affecting the ovary and in the staging of endometrial or cervical cancerous processes. MR findings are compared with the results of other techniques like Ultrasonography or Computed Tomography. The best advantages of MR imaging are the lack of radiation and the possibility of multiplanar studies of the pathologies. For these reasons we consider MR imaging a more accurate method for the study of neoplastic disease affecting the gynecologic sphere.
The results of MR imaging in diagnosing, and characterizing of prostatic malignant tumour, as well as its feasibility in assessing the extension are discussed in this paper. We also compared MR findings with the results obtained from trans-rectal ultrasonography and computed tomography. In particular, we emphasize the important role of MR examination with trans-rectal coil which is, at present, the most sensitive technique for the identification and characterization of prostatic tumours as well as for assessing their extension.
The effect on dentinal hypersensitivity from the use of a dentifrice containing 5.0% potassium nitrate, 1.3% soluble pyrophosphate, 1.5% PVM/MA copolymer, and 0.243% sodium fluoride in a silica base over a twelve-week period was compared to a matching placebo dentifrice without potassium nitrate. A total of sixty-seven subjects were entered into the study, and stratified into two balanced groups according to their baseline mean thermal (threshold) temperature (Thermodontic Stimulator) and baseline mean tactile (Yeaple Probe) sensitivity scores. The two groups were randomly assigned to use either the potassium nitrate/copolymer/pyrophosphate dentifrice or the placebo dentifrice. The two groups were well balanced with regard to their mean baseline thermal and tactile sensitivity scores, sex and age. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice and a commercially available soft-bristled toothbrush. Dentinal hypersensitivity examinations, which included tactile sensitivity, threshold thermal sensitivity, pain thermal sensitivity, air blast, and a visual analog scale were conducted at baseline, six weeks, and twelve weeks. All examinations were conducted by the same dental examiner. After six weeks' use of their assigned products, those subjects in the potassium nitrate/copolymer/pyrophosphate dentifrice group demonstrated statistically significant improvements (p < 0.01), as compared to the placebo dentifrice, in the following parameters: 1) tactile; 2) thermal (threshold and pain); and 3) air blast. After twelve weeks' use of their assigned products, those subjects in the potassium nitrate/copolymer/pyrophosphate dentifrice group again demonstrated statistically significant improvements (p < 0.01), in tactile, thermal (threshold and pain) and air blast sensitivity, as compared to the placebo dentifrice. It was concluded from this study that a dentifrice containing 5.0% potassium nitrate, 1.3% soluble pyrophosphate, 1.5% PVM/MA copolymer, and 0.243% sodium fluoride in a silica base is a clinically effective treatment for reducing dentinal hypersensitivity.
A randomized, two-compartment calculus clinical study of twelve-weeks duration was conducted among a group of calculus-forming subjects in the St. Louis area. The purpose of this parallel and double-blind clinical study was to compare the effect of a dentifrice containing 5.0% potassium nitrate, 1.3% soluble pyrophosphate, 1.5% PVM/MA copolymer and 0.243% sodium fluoride in a silica base, to that of a placebo dentifrice, with regard to supragingival calculus formation. The study examiner, using the Volpe-Manhold Calculus Index, selected a panel of calculus-prone men and women who had completed a one-month placebo regimen. The Volpe-Manhold Calculus Index scores and the number of completely calculus-free sites were recorded. One-hundred and fifteen subjects were entered into the study. After an oral soft and hard tissue examination, the subjects were given a complete oral prophylaxis and randomly assigned to use either the placebo or test dentifrice for a 12-week home-use period. They were prohibited from using any other means of oral hygiene during the study. After completing 12 weeks of twice-daily brushing at home using their assigned toothpaste and a standard soft-bristled toothbrush, subjects were again assessed for supragingival calculus deposits and calculus-free sites. The dentifrice containing 5.0% potassium nitrate, 1.3% soluble pyrophosphate, 1.5% PVM/MA copolymer and 0.243% sodium fluoride in a silica base, inhibited supragingival calculus formation by 54.4%, as compared to a 0.243% sodium fluoride silica-based placebo dentifrice. The mean Volpe-Manhold Calculus Index scores were compared statistically and the difference indicated statistical significance at probability of 0.01 by means of an analysis of covariance (ANCOVA). The number of calculus-free sites, a second parameter of efficacy, also was compared and demonstrated an absolute difference of 32.6% in favor of the group using the dentifrice containing potassium nitrate, soluble pyrophosphate and PVM/MA copolymer compared to a placebo dentifrice (37.8% vs 5.2%, respectively). An analysis of covariance indicated that this improvement showed statistical significance at a probability of 0.01.
OBJECTIVE: Relationships between immune and endocrine systems seem to occur in ovarian follicular fluids (FF). Lymphomonocytes have been found in preovulatory follicles and their specific products, cytokines [interleukin-1 (IL1), IL2], were demonstrated to inhibit steroidogenesis. Ovarian steroids, in turn, reduce the cytokine production from immune-competent cells. In the present study we evaluated whether lymphomonocytes are present in FF, and if both their subset distribution and their IL1 alpha and IL2 secretions, after activation with phytohemagglutinin (PHA), are similar to those of peripheral blood. Interferences of IL1 alpha and IL2 production by FF lymphomonocytes caused by isolated granulosa cells were also evaluated. PARTICIPANTS: The study was performed on 86 FFs obtained from follicles containing mature oocytes that were aspirated at the time of ovum pickup from 27 women undergoing controlled ovarian hyperstimulation with exogenous gonadotropins for an in vitro fertilization (IVF) program [IVF-embryo transfer (IVF-ET) or gamete intrafallopian transfer (GIFT)]. RESULTS: Lymphocytes were found in FF. The distribution of CD8+ and CD3+ lymphocyte subsets is equal to that in peripheral blood, but the percentage of CD11b+, CD16+, and CD4+ cells (its trend) is higher in FF than in peripheral blood. The amount of IL2 and IL1 alpha deriving from PHA-activated FF lymphomonocytes is similar to that of peripheral blood PHA-activated lymphomonocytes. Granulosa cells significantly blunt IL2 and IL1 alpha production by FF lymphomonocytes. CONCLUSIONS: These results suggest that preovulation, a migration of lymphomonocytes from the peripheral compartment to the follicle occurs. However, unfavorable effects of IL2 and IL1 alpha, cytotoxic and antisteroidogenetic activities, are counteracted by the products of granulosa cells. The higher amounts of CD11b+, CD16+, and CD4+ in FF suggest that they could be involved in other immune processes.
PURPOSE: This study compares the results of three ovulation induction protocols in polycystic ovarian disease (PCOD) patients undergoing an in vitro fertilization-embryo transfer (IVF-ET) program. A total of 85 cycles was studied. The patients were treated with clomiphene citrate (CC) plus human menopausal gonadotropin (hMG) (CC/hMG group), with purified menofollitropin (pFSH) plus hMG (pFSH/hMG group), and with pFSH/hMG plus gonadotropin releasing hormone analogue (GnRH-a) (analogue group). In the analogue group the suppression of luteinizing hormone (LH) with GnRH-a decreased the number of follicles < 12 mm on the day of human chorionic gonadotropin (hCG) administration and the number and percentage of immature oocytes retrieved and increased the percentage of mature oocytes retrieved. RESULTS: However, fertilization rates of oocytes, cleaved embryo rates, pregnancy rates following replacement, and pregnancy outcomes were not different. CONCLUSION: Although the suppression of the hypothalamic-pituitary-ovarian axis with GnRH-a in PCOD patients improved follicular synchrony and oocyte maturity, none of the ovulation induction protocols was superior to the others with respect to pregnancy rates and pregnancy outcomes.
Oral contraception (OC) in the premenopause has been recently proposed as treatment for control and prevention of the putative symptoms typical of this period of life. Indeed, menstrual cycle disturbances and climacteric symptoms frequently occur at this age. The major aim of normal contraception is resultant maintenance of normal sexual activity. The effects of one OC containing 20 mcg ethinylestradiol and 150 mcg desogestrel (EE/DOG) were studied. Treatment did not significantly modify both lipid metabolism (triglycerides, total cholesterol, HDL, LDL, Apo A, Apo B) and clotting system (fibrinogen, PT, PTT, antithrombin III, fibrinopeptide A). No significant modifications of oral glucose tolerance test (OGGT) occurred after EE/DOG treatment. Also, bone density was not modified during estro-progestinic administration. From our experience, if there are no risk factors such as smoking, obesity or hypertension, the OCs could be used until menopause for absolute contraceptive efficacy, good tolerance and lack of side effects.
GH therapy increases the ovarian response to gonadotropin stimulation in women presenting with ovaries that are relatively resistant to conventional gonadotropin therapy. As it is not completely certain whether GH modulates the actions of FSH on granulosa cells directly or via insulin-like growth factor-I (IGF-I) production, we studied its effect on steroid release by human granulosa cells obtained from subjects affected by unexplained or male factor infertility. In all subjects, superovulation for in vitro fertilization/embryo transfer was induced by treatment with gonadotropins or GH plus gonadotropins combined. The effects of the different in vivo treatments were evaluated in the conditioned medium obtained after the first 24 h of incubation; granulosa cells from patients treated with GH released higher amounts of estradiol and progesterone into the medium than did granulosa cells from patients treated with gonadotropins alone. When the release of steroid due to the in vivo treatment was exhausted, cells were subjected to increasing concentrations of GH in the presence or absence of 200 nmol anti-IGF Sm 1.2 monoclonal antibody (MoAb) or the antitype I receptor alpha IR3 MoAb. The results revealed that GH stimulates estradiol production in a dose-dependent fashion, and the presence of the MoAbs drastically reduces the GH effect. These data demonstrate that the established stimulatory effect of GH on ovarian function is dependent not only on the increased levels of circulating IGF-I, but also on a direct effect of GH on granulosa cells, which seems to be mediated at least in part by the autocrine action of IGF, particularly IGF-II. In fact, chromatographic analysis of medium conditioned by human granulosa cells revealed that these cells clearly produce IGF-II and IGF-binding proteins and only small amounts of IGF-I. Since GH appears to be able to increase the in vitro effect of both IGF-I and IGF-II, we can hypothesize a sensitization of the granulosa cells to the IGF-II produced by the cells themselves, which acts through the IGF-I receptor.
To obtain information on human pituitary intermediate lobe activity throughout the perinatal period, plasma alpha MSH immunoreactivity (IR) was measured in 106 newborns at delivery and during the first week of postnatal life. Subjects were divided into groups according to gestational age at birth, mode of parturition, and antenatal state of health. Plasma alpha MSH IR decreased progressively from severe preterm to fullterm neonates born by vaginal delivery (VD; P < 0.001) or cesarean section (CS) with and without prenatal distress (P < or = 0.001 in both cases). alpha MSH IR was due, in all studied conditions, to three major forms: desacetyl alpha MSH, alpha MSH, and diacetyl alpha MSH. Desacetyl alpha MSH was always the most represented form, but it decreased from 75-80% of the total in severe premature to 40-45% in mature infants. In term neonates, total alpha MSH IR values were higher in subjects born by normal VD than by elective CS (P < or = 0.05), in complicated than in normal VD (P < or = 0.01), and in CS performed because of fetal distress than in elective CS (P < or = 0.01). No significant difference was detectable in mature subjects in the percentages of the three alpha MSH forms in relation to the mode of delivery and fetal state during antenatal life or at parturition. Twelve hours after birth, total alpha MSH IR significantly decreased in all groups of term newborns, reaching a plateau of 0.8-1.4 pmol/L. In premature infants, similar concentrations were detectable by the fourth postnatal day. We conclude that 1) alpha MSH IR intermediate lobe secretion progressively decreases throughout the third trimester of pregnancy; 2) stress, including that pertinent to parturition, stimulates alpha MSH IR release; and 3) pituitary intermediate lobe activity declines shortly after birth independently of the maturity reached by the fetus, the mode of parturition, and the presence of antenatal chronic distress, although the process is slightly retarded in premature newborns.
Ortho HCV Elisa Test System 2nd Generation and Abbott HCV EIA 2nd Generation tests were used in 293 sera collected from dialysis patients in order to determine the prevalence of anti-HCV in this risk group and the sensitivity of the two tests. The agreement between the two tests employed was 98.3%. All reactive sera were confirmed using Ortho Riba and Abbott Supplemental tests. 91.9% sera were confirmed positive by Ortho RIBA and 100% by Abbott Supplemental test. The anti-HCV prevalence in haemodialysis patients increased with age, duration of dialysis treatment and number of transfusions. Our study confirms the higher prevalence of anti-HCV in haemodialysis patients using 2nd generation tests and their specificity.
Differential diagnosis between medical and surgical icterus is often difficult, if based on clinical data only. Echotomographic studies represent the first choice method between diagnostic imaging techniques. If a negative result is found (due to initial phase or an intermittent icterus) a new examination can be performed after few days; a scintigraphic study with HIDA can be also performed. If a positive result is found on echotomography, a CT scan can be performed and, if necessary, an ERCP or a TPC. MR imaging is an available technique to ameliorate the evaluation of lesion's extension and its relationship with adjacent vascular structures. Talking about therapeutic implications, we find quite useful to apply an endobiliar prosthesis during the first phase, in order to better understand the real extension of the lesion. Surgical treatment is justified, if a radical resection is possible and in all cases with a prognosis of over 6 months, because of the minor percentage of long time complications in traditional surgery with respect to interventional radiologic techniques.
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Before the introduction of computed imaging techniques like CT scan and MR, the differential diagnosis of lesions affecting the sellar and suprasellar regions was very difficult, more often impossible. These techniques contributed to ameliorate the typing of pathological tissues. Non neoplastic pathological findings of this region are very different and they can variate between phlogistic processes, vascular lesions, hamartomatous formations or congenital malformations. In this work we describe the characteristic changes of morphology and radiologic aspect in the diagnostic study of this region, using CT scan and MR imaging.
The above paper was aimed at defining the usefulness of MRI in the study of pathologies involving the penis. Disorders considered include Peyronie's disease, fibrosis of the penis, priapism, trauma, congenital anomalies, and tumors. In Peyronie's disease and in fibrosis of the penis, MRI permits to demonstrate the abnormal thickening of tunica albuginea and erectile tissue; after administration of gadolinium, it becomes possible in some cases to demonstrate plaques of the albuginea that are not palpable. In priapism, MRI is useful both for identifying the cause and for assessing the time elapsed since blood extravasation. In traumatic and congenital pathologies, MRI is essential for the acquisition of all information on anatomy that may be useful for selecting the most suitable surgical therapy. In neoplastic pathology, MRI has proved useful for accurately assessing the extension of lesions involving the basis of the penis.
In our experience, neoplastic lesions of the floor of the third ventricle are frequently responsible for neurologic and dysendocrine symptoms. Ct scan and MR imaging are the most reliable techniques of neuroimaging in the diagnostic study of neoplastic masses affecting this region. In this work, CT and MR appearance of lesions of the III ventricle floor are discussed with the aim of contributing to the differential diagnosis of neoplasms and their surgical and medical management.