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Biomedical subjects

F Beltrame

Publications and source records attributed to F Beltrame.

At least 37 records · Page 2Linked to original sources
PubMed1998

Physiologic evaluation of non-invasive pressure support ventilation in trauma patients with acute respiratory failure.

OBJECTIVE: To investigate the effectiveness of noninvasive (face mask) versus invasive (endotracheal tube) equal pressure values on blood gases and respiratory pattern and to evaluate the feasibility of using mask ventilation after the short term physiologic study. DESIGN: Open, prospective, physiologic study and uncontrolled clinical study. SETTING: Intensive care unit of a trauma center. PATIENTS: 22 intubated trauma patients were studied. INTERVENTIONS: Patients were intubated and ventilated in a pressure support mode (IPSV) of 13.5 +/- 1.5 cmH2O and a post end-expiratory pressure (PEEP) of 5.8 +/- 2.57 cmH2O. After a T-piece trial to assess patient's ability to breath spontaneously, patients were switched over to noninvasive pressure support (NIPSV). The pressure levels were set as during IPSV. Blood gases and respiratory parameters were measured during IPSV, during the T-piece trial, and after 1 h of NIPSV. After the physiologic study, all patients were asked if they wished to continue on NIPSV. The patient's subjective compliance with IPSV and NIPSV was measured by means of an arbitrary score. A successful outcome was defined as no need for reintubation. MEASUREMENTS AND RESULTS: IPSVand NIPSV showed no statistical differences for blood gas and respiratory parameters by using the same values of PSV (13 +/- 5 vs 12.8 +/- 1.7 cmH2O, NS) and PEEP (5.8 +/- 2.5 and 5.2 +/- 2.2 cmH2O NS). The median length of time on NIPSV was 47 h (range 6 to 144). All patients wished to continue on NIPSV, but 9 patients (40.9%) were reintubated after 54 +/- 54 h. Six of them died after 36 +/- 13 days while still on mechanical ventilation. There was no statistically significant difference in compliance score between IPSVand NIPSV. CONCLUSIONS: NIPSV is comparable to IPSV in terms of blood gases and respiratory pattern. The clinical uncontrolled study indicates that NIPSV could be used in selected trauma patients.

Acute Disease↗
PubMed1998

On the integration of healthcare emergency systems in Europe: the WETS project case study.

The European Union (EU) is characterized by a large number of different emergency healthcare (EHC) systems. In this situation, a common policy for healthcare emergency handling is largely prevented and is a cause of an increase of the costs associated with such systems all over Europe. There is, hence, a need for a homogenization and integration of healthcare emergency systems in Europe. This turns out to be difficult because of the ethical, political, legal, and technological differences and peculiarities of the European scenario and the large investments that would be needed in this sector. The process of integration passes through the identification of the main functionalities--driven by the user needs in their real life conditions--along with the technologies that are best fitted for supporting them. In this paper, several aspects related to these problems are analyzed and a real case study, drawn from the Project "Worldwide Emergency Telemedicine Services" (WETS), supported by the European Commission (DG-XIII), is presented. Within WETS, several pilot sites (in Italy, Spain, Greece, Denmark, and Iceland) consider different aspects of the integration of healthcare emergency systems with particular focus on the sharing of solutions that "traditionally" belong to different environments (i.e., land, air, and sea). The involvement of important hospitals, ship companies, airlines, and emergency health institutions allows us to devote a large part of this two-year project (1998-1999) to validate and demonstrate the results of the development phase in real-life conditions. Some more concrete details are given for the Italian pilot site, where the authors operate.

Emergency Medical Services↗
PubMed1998

Single-breath method for assessing the viscoelastic properties of the respiratory system.

In order to explain the time dependency of resistance and elastance of the respiratory system, a linear viscoelastic model (Maxwell body) has been proposed. In this model the maximal viscoelastic pressure (Pvisc.max) developed within the tissues of the lung and chest wall at the end of a constant-flow (V') inflation of a given time (tI) is given by: Pvisc,max = R2V'(1-e(-tI/tau2), where R2 and tau2 are, respectively, the resistance and time constant of the Maxwell body. After rapid airway occlusion at t1, tracheal pressure (Ptr) decays according to the following function: Ptr(t) = Pvisc(t) + Prs,st = Pvisc,max(etocc/tau2)+ Prs,st, where tocc/is time after occlusion and Prs,st is static re-coil pressure of the respiratory system. By fitting Ptr after occlusion to this equation, tau2 and Pvisc,max are obtained. Using these values, together with the V' and tI pertaining to the constant-flow inflation preceding the occlusion, R2 can be calculated from the former equation. Thus, from a single breath, the constants tau2, R2 and E2 (R2/tau2) can be obtained. This method was used in 10 normal anaesthetized, paralysed, mechanically ventilated subjects and six patients with acute lung injury. The results were reproducible in repeated tests and similar to those obtained from the same subjects and patients with the time-consuming isoflow, multiple-breath method described previously.

Adult↗
PubMed1997

Computer-based technique for cell aggregation analysis and cell aggregation in in vitro chondrogenesis.

No quantitative methods are currently available to measure different aggregation parameters in cell cultures. In this paper we describe a computer-based technique for the automatic and reliable analysis of cellular aggregates, starting from optical microscopy images of living cells grown in suspension. The method allows determination, on the same sample at different time intervals, of quantitative parameters, including aggregation percentage, average number of cells in aggregates, and aggregate size statistical distribution. To determine the number of cells in an aggregate starting from its two-dimensional microscopic profile, a model has been proposed and verified, using sphere packing theory. Algorithms have been tested on chondrocyte suspension cultures, where cell aggregation is a very early and critical event leading to cell differentiation. Using this technique for the analysis of chick embryo chondrocyte cultures, we observed that aggregate size and development kinetics depend on the culture conditions used. The method, with minor adaptations, is of potential use also in other cell systems to evaluate aggregation indexes or to study aggregation kinetics.

Animals↗
PubMed1997

Studies on the structure of sperm heads of Eledone cirrhosa by means of CLSM linked to bioimage-oriented devices.

We have used a confocal laser scanning optical microscope imaging device and a bioimage-oriented workstation equipped for augmented reality to study the helical sperm head of the octopus Eledone cirrhosa. This approach allows us to study different complex organisational motifs due to the spatial arrangement of linear helical structures. We consider this helical specimen an enlarged copy of one of the most important biostructures governing cell functioning such as chromatin-DNA. Moreover, this very same sample is made of highly compacted chromatin that can be studied at higher resolution, i.e., by means of scanning force microscopy. Fluorescence optical sectioning has been used to enter the spatial organisation. Three-dimensional images of single, twisted, and folded fibers are shown.

Animals↗
PubMed1997

Recent results in color compositing of three-parameter magnetic resonance scans as a preoperative aid to the management of upper limb sarcomas.

We report on improved image quality and some recent clinical results with volume-rendered, color composite, multiparameter, magnetic resonance (MR) datasets and their color histograms. In a previous article we demonstrated the major components of an interactive visualization environment for multiparameter T1-, T2-, PD-weighted MR volume datasets. These are compositing of the three parametric volumes, color volume rendering of the resulting composite, interactive segmentation of the tissues based on color cluster statistics derived from display of the three-dimensional (3D) histogram, and head-tracking stereo display. We herein review the system design and describe improvements to the quality of the color volume rendering, in the display of the 3D color histogram data, and in the specification of the volume renderer's opacity function. Finally, we report on some recent clinical results using our system.

Arm↗
PubMed1997

Simulation of soft-tissue tumor excisions: a multimodal interactive approach.

Total 3-D reconstruction of the tumor size, shape, and relations with surrounding structures using CT, MRI, sonography, and angiography images can make simulated radical resection of soft-tissue sarcomas possible, thus sparing normal tissues. With our approach, starting from three MR images for a given patient, a new single image representation of all three parameters is generated by using two different techniques on a workstation in a standard UNIX and X-11 environment. The first one is a transformation linking together the MR parameters and the RGB (red, green, blue) color components. The second one is an unsupervised segmentation method based on a number of neural and fuzzy models. We can dinamically render and update a stereo display using field sequential presentation of left and right eye views on the monitor, with Cristal Eyes LCD shutter eyewear (StereoGraphics Inc., San Rafael, CA) to view it. As 3D locating tool, a 3D locating control system based on low-frequency magnetic fields (Polhemus Fastrak) has been chosen. Simulations of soft-tissues excisions may be performed in this interactive environment with augmented-reality modalities. All this, in our experience, has greatly facilitated the simulation of soft-tissue sarcoma excisions.

Artificial Intelligence↗
PubMed1997

An "augmented-reality" aid for plastic and reconstructive surgeons.

Starting from MR and CT images for a given patient, a new single image representation of all parameters has been generated by using false-color techniques in a standard UNIX and X-11 environment. A transformation linking together the MR, CT parameters and the RGB (red, green, blue) color components has been used. Moreover an unsupervised segmentation method based on a number of neural and fuzzy models may directly produce segmented image volumes. Each image of the various sequences has been interactively displayed by using a specifically designed application. The resulting images have been displayed on a stereo monitor allowing the three-dimensional rendering of visual data through LCD shuttered glasses. Moreover, a 3-D control system based on low frequency magnetic fields has been used, while a bandheld Polhemus stylus could be used as an electronic knife for dissecting the 3-D data set and for defining flaps and grafts. Bone or soft-tissue contour can be analyzed, and sections can be removed from the model to allow a view of the underlying structures. Flaps and grafts obtained utilizing the above-reported techniques can be fitted exactly, without repeated removal and recarving. Nuances of depth, tapering, and arc are carved directly into the bone, while chances of asymmetry are markedly diminished. In this way, moreover, anesthetic times are reduced by more efficient utilization of operative time, which usually offsets the increased cost of imaging.

Artificial Intelligence↗
PubMed1997

Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project.

MERMAID is an EU financed telemedicine project with global reach and 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) will be considered while the full range of network choices (Digital land lines, Cellular/Wireless, Satellite and Broadband) will be tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

Emergency Medical Services↗
PubMed1997

Trichocyst membrane fate in living Paramecium primaurelia visualized by multimodal confocal imaging.

Trichocysts are secretory organelles located at the surface of several ciliates, docked at the plasma membrane. Their secretion is similar to other exocytic processes: the trichocyst membrane fuses with the plasma membrane, its content is released outside the cell, and the membrane is retrieved back into the cell. The fate of the trichocyst membrane in living Paramecium primaurelia was investigated by inducing massive synchronous exocytosis in the presence of fluorescein isothiocyanate-conjugated lectins or of cationized ferritin. The marker is trapped within the retrieved trichocyst membrane sac, and many regularly spaced, fluorescent ghosts are formed. As time proceeds, the number of labeled ghosts decreases, and few fluorescent vacuoles appear within the cell. The relationship between trichocyst ghosts and the vesicles of the phagosome-lysosome system was examined by labeling cells with Texas Red-conjugated bovine serum albumin, a fluorescent marker for phagocytosis. Starting from two confocal images of the same cell labeled with the two fluorescent probes, a new single image was generated by associating each image with a different red or green value. This multimodal analysis showed that trichocyst ghosts fuse with secondary lysosomes or are incorporated into digestive vacuoles. The vacuolar content is degraded and fluorescence is then found in the vesicles of the phagosome-lysosome system, and, at last, in small weakly labeled vesicles located on the cell surface.

Animals↗
PubMed1996

Time-variant analysis of organelle and vesicle movement during phagocytosis in Paramecium primaurelia by means of fluorescence confocal laser scanning microscopy.

Vital fluorescent dyes (FITC-albumin, Texas Red-albumin, and acridine orange) were used together with a confocal laser scanning optical microscope (CLSM) to display and analyze formation, movement, and fusion of vesicles during the phagocytosis of Paramecium primaurelia, in the x-y-z-t space. By immobilizing living cells pulsed with a food vacuole marker at successive times after chasing in unlabeled medium, the intracellular movement of food vacuoles from their formation at the cytostome to their egestion at the cytoproct was visualized, and food vacuoles were selected in a specific digestion stage. Small pinocytic vesicles are shown to evaginate from the vacuoles and move in the cytoplasm. These vesicles are transported toward the cytopharynx where they enlarge the membrane of the nascent food vacuoles or fuse with stage II food vacuoles, when the vacuoles of stage II increase their size, changing from an acidic to an alkaline status. A multimodal analysis of confocal fluorescence images and the false-color technique were used to visualize vesicle movement vs. time. Starting from three images of the same cell at succeeding time points, a composite image was generated by associating with each originally acquired image a different color corresponding to each sampling point in time. The composite image shows that vesicles move away from the food vacuole in a scattered manner exhibiting changes in direction.

Animals↗
PubMed1995

Image analysis of lysosomal activity during the early clonal life of Paramecium primaurelia.

Acid phosphatase activity was measured in individual cells by determining their optical densities through a scanning confocal laser microscope. The naphthol AS-TR (3-hydroxy-2-naphtoic acid 4'-chloro-2'-methylanilide) phosphate-hexazotized para-rosanilin method was used to visualise the acid phosphatase content in the light microscope. Evidence was obtained that the amount of enzyme varied in exponential growth phase cells as the fission age increased. By comparing the acid phosphatase activity with the rate of food vacuole formation, it appeared that the amount of enzyme inside the cells decreased in early clonal life, whereas the rate of food uptake increased. It was assumed that the reduction of acid phosphatase content could lead to a more extended life of vacuoles and to a decreased membrane recycling rate. In turn, the reduced supply of membrane available for food vacuole formation could partly be responsible for the decrease of the food uptake rate observed after the initial increase.

Acid Phosphatase↗
PubMed1995

Pressure control ventilation and minitracheotomy in treating severe flail chest trauma.

OBJECTIVE: To evaluate pressure control ventilation (PCV) delivered through a minitracheotomy in treating severe flail chest trauma. DESIGN: Case report. SETTING: Intensive care unit of a trauma center. PATIENT: A 34-year-old woman affected by flail chest trauma and acute respiratory failure, who was initially treated with tracheal intubation to obtain internal pneumatic stabilization. The patient failed extubation and noninvasive mask treatment (pressure support ventilation plus PEEP) due to poor chestwall mechanics. INTERVENTIONS: Minitracheotomy was performed and ventilation was achieved with high levels of inspiratory pressure (PCV or assisted PCV) to overcome the resistance of the cannula (Mini-Trach II, Portex, ID 4 mm). Esophageal and carinal pressures were monitored. Ventilatory treatment was always performed with the full cooperation of the patient; the patient's glottic function was always intact. The patient was successfully treated with pressure control ventilation delivered through the Mini-Trach. After 7 days of PCV, the patient was switched to assisted PCV. On the 20th day after admission, she was weaned from mechanical ventilation. CONCLUSIONS: We conclude that a suitable gas exchange and pneumatic stabilization in a flail chest condition can be achieved using minitracheostomic ventilation. At the same time, this treatment could reduce some side effects of traditional tracheal intubation.

Adult↗
PubMed1995

Acid phosphatase activity in mating type I and mating type II cell lines of Paramecium primaurelia.

The cellular acid phosphatase content, a marker enzyme for lysosomal activity, in Paramecium primaurelia mating type I and mating type II cells was determined by optical laser scanning microscopy. The naphthol AS-TR phosphatase-hexazotized pararosaniline method was used to visualize acid phosphatase activity by the light microscopy. Cell lines of both mating types were tested during culture life, from the early log phase to the death phase. The amount of acid phosphatase was higher in mating type II than in mating type I until the onset of the stationary phase, and then the values reversed. Indeed, during the log phase of growth, mating type II cells formed a higher number of food vacuoles, so that, by taking up a higher amount of bacteria, they sooner became deprived of food. It is suggested that, by lacking nutrients, their synthesis activities and acid phosphatase content were reduced as compared with mating type I cells.

Acid Phosphatase↗