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Biomedical subjects

C Aprile

Publications and source records attributed to C Aprile.

At least 37 records · Page 2Linked to original sources
PubMed1987

Circulating opioids and plasma renin activity in insulin-dependent diabetics with renal haemodynamic alterations.

Circulating opioids were studied in insulin-dependent diabetics with renal haemodynamic alterations. Higher circulating beta-endorphin (beta-EP) and lower beta-lipotropin (beta-LPH) levels were found in patients with glomerular hyperfiltration than in diabetics with normal glomerular filtration rate (GFR) and controls. Moreover, significantly positive correlations between beta-EP and GFR, and between beta-EP and renal plasma flow were demonstrated in these patients. On the contrary, reduced beta-EP levels were observed in diabetics with impaired GFR and overt nephropathy. Plasma renin activity was increased in diabetics with glomerular hyperfiltration and reduced in diabetics with overt nephropathy. Circulating opioids might, therefore, play a role in renal haemodynamic alterations, both in patients with early and advanced glomerular changes.

Adult↗
PubMed1987

[Lymphoscintigraphy in the study of lymphedema of the arms].

The aim of this work has been the study of the mechanism of lymph formation and drainage in the upper limb in patients with monolateral lymphoedema (15 limbs, L) in comparison with the apparently healthy limb (S) as well as with a control group (8 limbs, C). After interstitial injection of 99mTc sulphur micro-colloid, scans were obtained employing a LFOV camera linked to a data processor. Results were expressed as percentage of the id removed from the injection site 1 and 6 hr pi, mean T6%/h it is (T6-T1)/5 and percentage lymph nodes uptake at the same times. Mean T6%/h is significantly different between C and L, but not between L and S, while lymph node uptake at 6 hr shows a significant difference even between C and S. Quantitative lymphoscintigraphy appears to be a feasible indicator of early changes in the lymph pathophysiology and supports the hypothesis that lymphoedema generally arises from a predisposing congenital pathology.

Arm↗
PubMed1986

Assessment of split renal function with 99mTc-aprotinin.

The aim of this work is to correlate the net kidney uptake of 99mTc-aprotinin (TcA) in 103 subjects with separate effective renal plasma flow (ERPF) and some blood chemistry parameters at 90, 180, and 360 min postinjection both in the normal and diseased kidney. Correlations found with separate ERPFs are highly significant at any time (P less than 0.001). However, although the slope of the regression line is steeper at 180 min, r tends to deteriorate slightly with time postinjection and a higher intercept on the y axis; this pattern is more pronounced if diseased kidneys are considered separately. The following are probably related to the renal handling of TcA: Early scans better reflect blood flow to the kidney, while later scans are more related to the metabolism/excretion tubular mechanisms; correlations found with urea, creatinine, urea clearance, and creatinine clearance are highly significant at any time; in 20 additional patients with diseased kidneys, renal uptake measurements done 360 min postinjection first with TcA and then with DMSA showed better correlations with ERPF employing TcA. Our results indicate that TcA is a feasible indicator of split renal function even at 90 min postinjection when a scan is easily carried out on an outpatient basis.

Adolescent↗
PubMed1986

The role of meta-iodo [131I]benzylguanidine (MIBG) in the diagnosis and follow-up of neuroblastoma.

Fourteen scans employing the adrenergic blocking agent [131I]MIBG were performed on 10 children with neuroblastoma (NB) or ganglioneuroblastoma (GNB). The scans were negative in 5 cases, and 1 further case produced doubtful results in both the MIBG and CT scan tests. In 4 cases, very positive results were obtained with clear vision of the primary tumor and its metastases. In 1 case, which demonstrated partial differentiation of the outer part of the tumor mass toward GNB, a differentiated tumor specimen did not reveal significant uptake of the tracer. Half-lives of the tracer as measured by external detection in the period 24-48 h after injection were reduced after successful therapy. MIBG scanning appears to be a feasible indicator of NB adrenergic activity, and it can assume a primary role in the staging and follow-up of NB. Higher tumor uptake of the [131 I]MIBG and low background offer new perspectives in the radiometabolic treatment of MIBG.

3-Iodobenzylguanidine↗
PubMed1984

Sustained-release anhydrous theophylline in preventing exercise-induced asthma.

A number of drugs have been taken into consideration as to their efficacy in preventing exercise-induced asthma (EIA), which may be a reliable model for the investigation of bronchodilating agents. 15 asthmatic patients (mean age 21.1 +/- 10.7), EIA positive (free running test), were selected for a double-blind cross-over study of a sustained-release theophylline preparation against placebo. Patients underwent four subsequent bronchoprovocation tests by means of free running, at a 3-hours' interval, with a prior administration (3 h before the first test) of the drug at the dose of 7-8 mg/kg or the placebo. Lung function was tested (FEV1.0, FEF50, FEF25, sGaw) after the four induction tests as regards to the plasma concentrations of theophylline. After 6, 9 and 12 h, respectively, from administration of the drug, theophylline plasma levels between 7 and 9 micrograms/ml were found, which are to be considered more than satisfactory after an acute administration. A continuous protective activity has been noted against the exercise stress, with a significant difference between drug and placebo, for all lung function parameters with the obvious exception of the first one in which a satisfactory level of theophylline absorption was not reached. The finding of this new positive aspect of the drug investigated appears to be extremely interesting, particularly if added to the already well-known therapeutic activity, and to the fact that often other classes of drugs do not show a good correlation of protective action against EIA and prevention of spontaneous asthmatic attacks.

Adolescent↗
PubMed1984

99mTc-aprotinin: comparison with 99mTc-DMSA in normal and diseased kidneys.

Aprotinin (A) and DMSA labelled with 99mTc were compared in patients with normal (NK, n = 12) and diseased kidneys (CRF, n = 13) by means of quantitative serial scans and measurements of blood clearance and urinary excretion. Serial scans only were obtained in additional 13 patients. Scan quality in the NK patients was essentially equal: faster blood clearances, reduced urinary excretions and higher fixations of A in the target compensated for the increased liver uptake. On the other hand, the scan quality in the CRF patients was definitely superior with A, allowing detection of residual functioning parenchyma also in severe kidney failure. Correlation between the net kidney uptake 6 hrs p.i. and the separate hippuran clearance rate was better with A than with DMSA, indicating the feasibility of A in evaluating relative renal function.

Adult↗
PubMed1980

Method for the determination of cerebral blood flow in conscious rabbits.

A procedure for the determination of cerebral blood flow by the local clearance method after intracarotid injection of 133Xe in the conscious rabbit is described. The inert radioactive indicator is injected into a permanent nylon catheter equipped with a two-way Gordth's needle inserted into the common carotid artery and filled with heparin, emerging behind the shoulders of the animals. All branches of the homolateral common carotid artery except the internal carotid artery were ligated. Studies of the distribution of colored tracers (dark blue ink) and radioactive tracers (99mTc albumin microspheres) show that the main localization of the injected indicator is within the homolateral hemisphere. Brain to blood partition coefficients of 133Xe are worked out for rabbit's gray matter (0.576 +/- 0.048) and white matter (0.808 +/- 0.023). The slope method for first and second component of the wash-out Xenon curve is used for CBF calculations. CBF determinations in 9 normal rabbits result in 84.27 +/- 5.59 and 16.69 +/- 2.44 ml/min x 100 g tissue, respectively, for the fast and slow component. Significant changes do not occur in serial determinations within 2 hr.

Anesthesia↗
PubMed1978

Accumulation of 99m Tc-Sn-pyrophosphate in pleural effusions.

Accumulation of 99m Tc-Sn-pyrophosphate in pleural effusions has been evaluated in 56 patients grouped as follows: 8 with bacterial effusion (Group A), 27 with malignant effusion treated by local and/or parenteral antitumor chemotherapy (Group B), 21 with malignant effusion treated only by supportive therapy (Group C). Results, expressed as effusion to plasma PPi ratio, ranged from 0.1 to 0.28 in group A, from 0.04 to 0.64 in group B and from 0.60 to 1.73 in group C, with significant differences among the three groups. In no case was uptake found in cells of the sediment. Chemical analysis (including total and ionized calcium, total protein, acid and alkaline phosphatase) of plasma and exudate in neoplastic patients showed a slight, but significant, difference between groups B and C as regards plasma-effusion gradient for total calcium and acid phosphatase. Negative correlation also exists between effusion to plasma PPi ratio and plasma-exudate gradient for ionized calcium in neoplastic patients. The data support the hypothesis that acid phosphatase content and calcium gradient are among the factors involved in the mechanism of PPi accumulation in pleural effusions.

Diphosphates↗
PubMedDate not supplied

Determination of albuminuria in type 1 and type 2 diabetic patients with microproteinuria and overt nephropathy. Comparative evaluation between a radial immunodiffusion procedure and a highly sensitive radioimmunoassay.

We have studied the correlation between urinary albumin excretion rate evaluated by a radial immunodiffusion technique and a highly sensitive radioimmunoassay in type 1 and type 2 diabetic patients with microproteinuria and overt clinical nephropathy. Several statistically significant correlations were found between urinary albumin excretion rate measured by radial immunodiffusion and by radioimmunoassay, both in patients with microproteinuria and overt nephropathy. Moreover, statistically significant correlations between urinary albumin excretion rate, albumin clearance and total urinary protein excretion rate were observed in each of the groups studied. The radial immunodiffusion procedure can therefore be considered a useful and sensitive method for the evaluation of urinary albumin excretion rate both in diabetic patients with microproteinuria and in patients with overt clinical nephropathy.

Albuminuria↗
PubMedDate not supplied

Radioguided sentinel lymph node detection in vulvar cancer.

Lymph node status is the most important prognostic factor in vulvar cancer. Histologically, sentinel nodes may be representative of the status of the other regional nodes. Identification and histopathologic evaluation of sentinel nodes could then have a significant impact on clinical management and surgery. The aim of this study was to evaluate the feasibility and diagnostic accuracy of sentinel lymph node detection by preoperative lymphoscintigraphy with technetium-99 m-labeled nanocolloid, followed by radioguided intraoperative detection. Nine patients with stage T1, N0, M0, and 11 patients with stage T2, N0, M0 squamous cell carcinoma of the vulva were included in the study. Only three cases had lesions exceeding 3.5 cm in diameter. Sentinel nodes were detected in 100% of cases. A total of 30 inguinofemoral lymphadenectomies were performed, with a mean of 10 surgically removed nodes. Histological examination revealed 17 true negative sentinel nodes, 2 true positive, and 1 false negative. In our case series, sentinel lymph node detection had a 95% diagnostic accuracy, with only one false negative. Based on literature evidence, the sentinel node procedure is feasible and reliable in vulvar cancer; however, the value of sentinel node dissection in the treatment of early-stage vulvar cancer still needs to be confirmed.

Adult↗
PubMedDate not supplied

Radioguided surgery for gastrinoma: a case report.

AIMS AND BACKGROUND: Gastrinomas are the most common neuroendocrine tumors of the duodenopancreatic region. Surgical resection is the primary type of radical treatment. METHODS AND STUDY DESIGN: At the Institute of General, Gastrointestinal and Breast Surgery we treated a patient with a duodenal gastrinoma that was diagnosed and localized by means of selective celiac-mesenteric angiography and labelled octreotide scintigraphy. Surgery was performed using a radioguided technique; in this way we easily detected the small tumor and discovered another tracer-uptaking lesion that turned out to be a metastatic lymph node. RESULTS: Surgical resection is the ideal treatment for sporadic gastrinoma: it improves quality of life, prolongs survival, and reduces the incidence of metastases, with a modest percentage of complications and practically zero mortality. Meanwhile, medical treatment is being reevaluated, particularly in the case of metastatic disease or polyendocrine MEN1 syndrome. A fundamental aspect in the management of gastrinomas is tumor localization. Endoscopic ultrasonography and labeled octreotide scintigraphy (Ostreoscan) proved to be more effective than the usual imaging modalities. Intraoperative ultrasonography gastroscopy for duodenal transillumination and repeated measurement of blood gastrin levels should be performed intraoperatively in the surgical treatment of gastrinomas. CONCLUSIONS: The clinical application of radioguided surgery for tracer-uptaking endocrine tumors is still controversial. In our case the decision to use this method was influenced by the fear that the patient's obesity and the effects of previous surgery could hamper the identification of the small tumor.

Aged↗
PubMedDate not supplied

Intraoperative radioimmunolocalization of colorectal cancer: a review.

Although intraoperative radioimmunolocalization (IORIL) is gaining wider acceptance, several limits inhibit a more extensive clinical use. In this paper the following topics will be discussed: 1) the clinical approach, that is, the combined use of immunoscintigraphy and IORIL after a single MAb administration or the use of non-imaging 125 I MAb; 2) the detector type and its collimation and shielding; 3) the nuclides employed, and 4) the background problem. The clinical results of our and other groups show a sensitivity that is generally higher than 0.75 with a high positive predictive value. The detection rate of occult lesions is in the order of 20% of all explored sites. However, the current state of detector and MAb technology do not allow to achieve better results; probably the results can be improved by the use of bispecific MAb or the avidin-biotin system.

Clinical Trials as Topic↗
PubMedDate not supplied

Evaluation of separate renal function by means of 99mTc-aprotinin uptake test.

The possibility that relative kidney uptake of technetium-99m aprotinin (TcA) might be indicative of separate renal function was investigated in 89 patients who underwent both effective renal plasma flow (ERPFs) and glomerular filtration rate (GFR) determination. A reference group consisted of 27 healthy volunteers, studied only with TcA. The correlation with ERPFs (r = .73) was similar to that previously reported and confirmed. The correlation with GFR (r = .68) was better if a subgroup of renal units with TcA uptake lower than 16% (lower normal limit) was considered. Most likely, glomerular filtration is a limiting factor of the tubular uptake of TcA, and when GFR is reduced, both parameters decrease in the same manner, while if GFR is normal the two parameters are relatively independent. The correlation between TcA and GFR in 32 children was very similar to that found in adults. TcA uptake test seems to be a useful indicator of separate renal function, providing morphological information at, the same time.

Adolescent↗
PubMedDate not supplied

Iodine deficiency and increased risk from radioactive iodine intake in nuclear medicine personnel.

Since the entity of the stable endogenous iodine pool is inversely related to the probability of thyroid uptake of radioactive iodine isotopes in subjects exposed for professional reasons to radioiodine intake, we evaluated the urinary iodine excretion, which is a reliable indicator of stable iodine daily intake, in 19 subjects of a nuclear medicine department. Seventeen out of 19 subjects showed a reduced iodine elimination < 150 mcg iodine per g of urinary creatinine, while the values of TSH and free fractions of T3 e T4 were within normal limits. Thyroglobulin levels were increased in 5 subjects only, all with reduced iodine excretion. Iodine deficiency is still present in several european areas and is responsible for several thyroid diseases including cancer; it is also responsible for increased thyroid dosimetry after accidental intake. According to Breuer, an increased radiation rate to bone marrow and ovaries is expected in subjects with a reduced endogenous iodine pool. On account of these results, we recommend to monitor the urinary iodine excretion in personnel exposed to the risk of radioiodine contamination and correct their dietary daily intake, thus reducing organ dosimetry not only in normal working conditions, but also in case of accidental internal contamination.

Adult↗