Biomedical subjects
Publications and source records attributed to D Antonelli.
A Soviet nuclear pacemaker is described. It is a large VOO bipolar pacemaker, probably nonprogrammable. It has unique electrode connectors. No isotope leak or excessive radiation hazard was detected. Because we had no knowledge of its end-of-life markers and because of the impossibility of assuming long-term safety, the device was removed.
After having emphasized the importance of interdisciplinary diagnostic approach to the sexual impotence as a symptom and having made some comments about the erection's physiology, the Authors, according to their experience, take drugs into consideration for elective treatment of sexual intercourse.
The best knowledge of the biological and genetic mechanism involved in the process of metastasizing must determine the attempt of elaborating new therapeutical modalities. The authors show the sequential events of the metastasizing process based on the most recent theories, underlining the way the organotropism of the neoplastic cells can be the explanation of the otherwise inexplicable metastases.
The authors briefly illustrate some biological and epidemiologic characteristics of the malignant urologic tumors; then they describe the modalities of metastasizing underlining that this process is determined not only by hematic and lymphatic dissemination but also by sequential and complex events "metastatic fall", involving multiple guest-tumor intersections to the organotropism of the neoplastic cells and to their intrinsic aggressiveness and to the histological type of tumor. Afterwards the authors analytically analyze the most important malignant neoplasms of the urogenital apparatus either as clinical importance or as statistic incidence.
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A case is presented in which a to-and-fro murmur was heard at auscultation. Cross-sectional echocardiography, combined with Doppler examination, showed that the murmur was produced by flow across the neck of a left ventricular pseudoaneurysm.
A case of a week old female baby, admitted because of apathy, hypothermia, dyspnea, jaundice and cyanosis is described. She had the characteristic phenotype of Turner's syndrome with normal karyotype. Signs of severe heart failure were present. Therapy with diuretics, digoxin, dopamine and mechanical ventilation were unsuccessful, and the patient died several hours after her admission. The anatomopathological examination revealed the presence of hypoplastic left heart syndrome with mitral atresia and aortic atresia, atrial septal defect, double outlet right ventricle, and a patent ductus arteriosus.
Myocarditis may present with a variety of electrocardiographic patterns. However, polymorphous ventricular tachycardia (PVT), potentially a highly malignant ventricular arrhythmia, has not been described in acute myocarditis. As far as we know, this is the first report of this arrhythmia in that condition. It is characterized by unusual resistance to both the common pharmacological and nonpharmacological approaches. This report of a 28-year-old woman demonstrates the role of PVT as a potential cause for sudden death among patients with subclinical myocarditis.
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A 75-year-old man began suffering from intermittent episodes of superior caval venous syndrome, seven years after implantation of an endocardial pacemaker via the right cephalic vein. The obstruction of the superior caval vein was confirmed by venography and computed tomography of the chest. Changes of the intrathoracic pressure were considered to be the mechanism responsible for the intermittence of the syndrome.
In order to assess prospectively the incidence and significance of venous thrombosis early after permanent transvenous pacemaker implantation venographic studies were carried out in 40 consecutive patients. The venograms performed between 1 and 6 months (mean 4 months) after the implantation were normal in 31 patients (77%), in six patients (15%) they showed partial venous obstruction and in three patients (8%) total obstruction. Between 6 and 12 months (mean 9 months) the venograms of five patients, that were previously normal, showed partial venous thrombosis. No changes were found in the venograms performed later. Only two of 14 patients with thrombosis of the great veins was clinically symptomatic and developed arm edema, that resolved spontaneously within about a month. No difference in incidence of abnormal venograms was found according to the type of insulation, the polarity of the electrode and the route of entry.
Female conjoined twins were delivered after 42 weeks' gestation, but they died within a few minutes of birth. They were dicephalus, dibrachius and dipus conjoined twins with two separate spines and fusion of the trunk and the pelvis. The pericardial sac was common, and the heart was a single structure. The atrial complex was a common chamber with an attempt at division into two parts by a circular ridge of tissue; the ventricular complex was formed by three chambers which were all communicating between each other in the superior margin of their muscular interventricular septum.
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Physiologic factors of metabolic energy cost as well as selected mechanical characteristics of gait are described in a group of 40 presumably normal men and women between the ages of 20 and 60 years. Special emphasis was placed on unrestrained (free cadence) walking to provide a reliable baseline for comparison to persons with physical gait impairments. Velocity of walking was the most important factor in determining oxygen uptake and was independent of age or sex. An empirical equation was established relating oxygen uptake to the speed of walking. The average velocity for men in unrestrained walking trials was 89 meters per minute; for women 74 meters per minute. These differences were related to the greater stride length in men. The average cadence selected by both sexes was 116 steps per minute. None of these factors was age dependent. Of the physiologic measures only systolic blood pressure was age dependent predictably rising with age. The mean heart rate was 103 beats per minute and did not vary significantly between men and women. The mean respiratory rate was 19 per minute; the mean respiratory quotient, 0.85, neither being age or sex dependent. Oxygen uptake values averaged 12.95 ml/kg-min for the population studied and again were neither age nor sex dependent.
A comparison of selected gait parameters and the energy cost of prosthetic walking was made in seventy patients with unilateral traumatic and vascular amputations. Amputations above the knee, below the knee, and at the Syme's level were compared in both groups of amputees, and a control group of forty normal subjects also studied. In both groups of amputees performance was significantly better the lower the level of the amputation. When preservation of function is the chief concern, amputation should be performed at the lowest possible level.
Twenty-three ambulatory children with spastic diplegic cerebral palsy were evaluated clinically and by electromyography before and after hip-muscle surgery. The stretch tests originally designed to distinguish specific muscle tightness and spasticity were found to be non-specific when tested by electromyography. Ambulatory electromyograms using needle electrodes and telemetry generally showed decreased activity in the released muscles and, on occasion, changes in activity in muscles not operated on. These unanticipated changes after release may explain some of the unpredictability of results of such procedures in cerebral palsy.
Using an instrumented cadaver lower extremity, the forces in the quadriceps, patella, and tibia during flexed-knee stance were measured and the calculated and experimental data were found to correlate with an average discrepancy of 6 per cent. The quadriceps force required to stabilize the knee was 75 per cent of the load on the femoral head at 15 degrees of knee flexion, 210 per cent at 30 degrees, and 410 per cent at 60 degrees. Stresses at the tibiofemoral and patellofemoral joint surfaces increased in similar fashion. The quadriceps force was equivalent to 20 per cent of average maximum quadriceps strength at 15 degrees and to 50 per cent at 30 degrees, as determined from torque tests on five normal subjects.