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Biomedical subjects

C Manni

Publications and source records attributed to C Manni.

At least 19 recordsLinked to original sources

Integrated multislice CT and Tc-99m Sestamibi SPECT-CT evaluation of solitary pulmonary nodules.

PURPOSE: The purpose of this study was to evaluate efficacy of multislice computed tomography (MSCT) and single photon emission computed tomography (SPECT)-CT with Tc-99m Sestamibi in the assessment of solitary pulmonary nodules of uncertain significance. Scintigraphy was performed using a 'hybrid' g-camera that allows simultaneous acquisition of SPECT and CT images, with interesting results in diagnostic oncology. MATERIALS AND METHODS: Between September 2003 and August 2004, 23 patients with a solitary pulmonary nodule detected on CT underwent SPECT-CT using Tc-99m Sestamibi as a radiotracer. Nodules with positive scintigraphy were immediately subjected to biopsy or surgical resection. Nodules with negative scintigraphy were followed up after 3-4 months by MSCT with automatic segmentation software (Advanced Lung Analysis, ALA) and histological characterisation. RESULTS: Of the 23 nodules (size range 0.8-2 cm) discovered with MSCT, 11 showed intense uptake of Tc-99m Sestamibi. Ten lesions were true positive: seven adenocarcinomas, one squamous cell carcinoma, one large cell carcinoma and one metastasis. The only false positive was histologically classified as a large cell granuloma. Twelve lesions had negative scintigraphy: five fibrous lesions, three hamartomas, three granulomas and one adenocarcinoma (false negative). Benign nodules without tracer uptake underwent another CT scan 3-4 months later, which confirmed stability of the nodule size. Correlation of Sestamibi SPECT with histology showed sensitivity (Se) of 90.9 %, specificity (Sp) of 91.6 %, diagnostic accuracy of 91.3 %, positive predictive value (PPV) of 90.9% and negative predictive value (NPV) of 91.6 %. CONCLUSIONS: The integrated use of MSCT and Tc-99m Sestamibi SPECT-CT could be very useful in the management of solitary pulmonary nodules (SPNs). In particular, in our preliminary study, scintigraphy provided significant diagnostic information to differentiate benign from suspicious pulmonary nodules. The use of scintigraphy could be helpful to anticipate histological assessment and surgical treatment of SPNs identified at CT.

Adenocarcinoma↗

[Sentinel lymph node for breast cancer: remove less to know more].

BACKGROUND: Our aim was to study the value of sentinel lymph node (SLN) biopsy in patients with breast cancer seen at a community hospital. METHODS: Consecutive cases receiving primary treatment for unicentric breast cancer less than 3 cm in diameter were prospectively studied from January 1999 to July 2000. All patients signed a detailed informed consent. The majority of patients (89%) underwent a combined technique of intradermal injection of 0.3-1.2 mCi of (99)Tc and 1-3 cc of Patent Blue at the biopsy site. Intraoperative localization was performed with a hand-held gamma probe. The first 15 patients underwent routine back-up lymphadenectomy. Thereafter, only patients with positive SLN, suspicious findings, or personal preference underwent formal axillary dissection. RESULTS: One hundred eight cases were included in the study with a median age of 61 years and a median diameter of the breast tumor of 1.5 cm. Success rate for identification of SLN was 94% (101/108 cases). A total of 917 additional lymph nodes were removed after SLN biopsy (median 6.5 lymph nodes/patient). Correlation between SLN and the final axillary status was 98%. In 20/36 patients (61%) with positive axillary status the sentinel lymph node was the only positive one. Ten patients had only microscopic foci of cancer found in the SLN. Sixty-seven patients (62%) could have avoided axillary dissection becouse the SLN was found, it was negative, and there were no other intraoperative suspicious findings. CONCLUSIONS: SLN biopsy is accurate and easily reproduced. Our data confirms that the majority of breast cancer patients may no longer need routine axillary lymphadenectomy.

Adult↗

Muscular uptake of Tc-99m MIBI and TI-201 in Duchenne muscular dystrophy.

Lack of dystrophin, a protein localized to the inner surface of the sarcolemma of the muscle fiber, is the cause of Duchenne type muscular dystrophy. Plasma membrane damage of the muscular fiber occurs, followed by Ca++ influx into the fibers. There is severe mitochondrial damage in dystrophic but still viable fibers. Five children aged 5-7 years were studied with MRI, TI-201, and Tc-99m sestamibi scintigraphy of the thighs. These three methods showed that the sartorius is the least damaged muscle in Duchenne type muscular dystrophy. MRI showed mild damage of adductors and quadriceps; TI-201 scintigraphy showed a marked reduction of radioactivity in the same muscles; Tc-99m sestamibi uptake occurred only in the sartorius muscle; the quadriceps was not imaged and adductors showed a faint image. A decrease of water in muscular fibers as well as fatty fibrous substitution, occurs after death of the fibers, whereas plasma membrane and mitochondrial damage reduced the uptake of tracers when the fiber is still viable. The interesting mismatch between sestamibi and TI-201 can be explained by considering that the cellular mechanism of uptake and retention of Tc-99m sestamibi involves both plasma membrane and mitochondria, whereas the uptake of TI-201 is only affected by plasma membrane damage.

Child↗

Thallium-201 scintigraphy and chemotherapeutic response in rhabdomyosarcoma.

Thallium-201 scintigraphy was used to evaluate chemotherapeutic response in a case of rhabdomyosarcoma treated with epirubicin. A scintigraphic semiquantitative index of tumor viability was correlated with MRI and clinical assessment. Both imaging studies were performed before therapy and after treatment involving a cumulative dose of 640 mg/m2 of epirubicin. A very good inverse correlation was observed between Tl-201 uptake and tumor necrosis evaluated by MRI, leading to the conclusion that sequential Tl-201 scintigraphy may have a role not only in delineating the extent of the tumor, but in objectively assessing tumor response to therapeutic interventions. The proposed scintigraphic method is much simpler to perform and less expensive than MRI-derived semiquantitative measurement of tumor necrosis.

Adult↗

[A clinico-statistical study of the anatomico-clinical and immunohistochemical correlations in chronic lesions of the oral cavity].

A series of 191 biopsies of the oral cavity (epulides, cysts and granulomas) carried out in 1975-76 (104 cases) and 1985-86 (87 cases) is reported. Data regarding age, sex, site, histopathological diagnosis, dimensions of the lesions and type of operation were processed on an AT mod 280 computer in a file specially created using an Ashton Tate DB 111 Plus. Percentage values relating to epulides proved substantially unchanged. Those regarding cysts showed a particularly evident increase in males, while those relating to granulomas showed a decline in both sexes. From the immunopathological viewpoint, angiomatous epulides, prevalent in the female sex, presented a structural framework different to that of plasma cellular epulides, testified by the presence of vessels lined with endothelia reactive to fucose and with scanty plasmocyte immunoglobulin component.

Age Factors↗

Anticatabolic properties of branched chain amino acids in trauma.

The anticatabolic properties of branched chain amino acids enriched protein solutions in 22 patients with multiple trauma have been evaluated. Nitrogen balance, nitrogen output, the daily change of blood urea nitrogen, plasma albumin and total protein levels were recorded daily. Each 2 days free amino acids and 3-methyl histidine urinary concentrations were measured. The results obtained in the study suggest that in trauma patients high ratios of essential amino acids/total nitrogen are needed and that amino acid solutions enriched in branched chain amino acids are most effective in preventing muscle catabolism and promoting protein synthesis.

Adult↗

[Rudolf Frey].

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Anesthesiology↗

Biochemical changes in acute respiratory failure.

A study has been carried out on patients presenting respiratory failure from chronic obstructive lung disease. Acid-base balance, electrolytes and amino acids levels have been studied in plasma and in cerebrospinal fluid (CSF) of patients in hypercapnic coma and results compared with those observed in patients with primary acute hypercapnia. Additional cardiopulmonary measurements were made. The study has shown evidence of significant modification of the distribution ratios of plasma and CSF electrolytes and amino acids, particularly in the patients with coma. The changes seem to be related to variations of the transmembrane potentials and alterations of some metabolic pathways involved in the homeostasis and in neurotransmission. Finally some of the changes of amino acid in plasma and CSF appear significantly correlated to variations in pulmonary function and to modification of acid-base balance observed both in plasma and CSF.

Amino Acids↗