Biomedical subjects
Publications and source records attributed to F De Luca.
A case report of febrile neutrophilic dermatosis as previously described by Sweet. The acute febrile illness is accompanied by plaque eruption and a positive toxoplasma indirect fluorescent antibody (IFA) test. Moreover, clinical and histopathological manifestations were compatible with the cutaneous reactive manifestation of toxoplasmosis and disappeared only after specific therapy.
In 4/37 (10.8%) children, adolescents and young adults with successfully shunted hydrocephalus, puberty occurred or was occurring precociously, at an age ranging from 7.5 to 8.6 years, with a consequent impairment of their effective or predicted adult height as compared to the familial target height. All four patients had undergone a surgical intervention for the insertion of a ventricular-atrial or a ventricular-peritoneal shunt during the first year of life; since the last surgical shunt revision (at the age of 5 years) no relapse of hydrocephalus had been recorded. The authors conclude that precocious puberty is to be regarded as a not infrequent long-term complication in patients with successfully shunted hydrocephalus.
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Significant high titres (1:400-1:25,600) of circulating thyroid microsomal antibodies (MCHA) were found in the sera of 5 out of 59 non-ketoacidotic, insulin-dependent diabetic (IDDM) patients (mean age 14.5 years). Among these five patients (four females, one male), all of whom were over 11 years, two also had thyroglobulin antibodies. Increased thyrotropin (TSH) response to TRH was found in 3/5 MCHA positive patients and in 3/54 without circulating MCHA. Serum thyroxine (T4) and free T4 (FT4) average values were significantly lower (P less than 0.01 and P less than 0.001) in diabetics (7.1 +/- 1.8 micrograms/dl and 10.2 +/- 3.1 pg/ml, means +/- SD) as compared to normal sex and age matched controls (8.9 +/- 1.9 micrograms/dl and 12.2 +/- 2.2 pg/ml, respectively). T4 and FT4 values were inversely related to the duration of the disease. Subnormal T4 values were found in six (five females and one male) patients, four of whom had subnormal FT4 values. No patient had low triiodothyronine (T3) and high reverse T3 (rT3) values, i.e. none displayed the biochemical pattern of the 'low T3 syndrome' described with ketoacidotic status. This indicates also a satisfactory compensation of IDDM in all the patients. At the time of study no patient (including also those with circulating MCHA and TGHA and with TSH hyper-response to TRH) showed either thyroid size enlargement or clinical features of thyroid dysfunction including impaired growth and bone age retardation.
Several parameters of thyroid function were studied in 112 non-ketoacidotic youngsters with insulin-dependent diabetes mellitus (IDDM). Levels of thyroxine (T4), reverse triiodothyronine (rT3), thyroxine-binding globulin (TBG) and T3 were lower than in controls, whereas FT4, and FT3 were normal. T4 levels in IDDM patients were positively related to T3, rT3 and TBG, and inversely related to haemoglobin A1 (HbA1). However, only 4 patients showed biochemical hypothyroidism (T4 less than 5 micrograms/100 ml), whereas their FT4, FT3 and thyroid-stimulating hormone (TSH) levels were normal. Concurrent variations of T3 and rT3 levels were found in IDDM patients; thus, their T3/rT3 ratios were stable or higher than in controls, indicating that peripheral deiodination of T4 is preferentially oriented to production of rT3 only during ketoacidosis. Although changes in thyroid function may reflect the degree of metabolic control of diabetes in a large population, the clinical usefulness of serum thyroid hormone measurements in an individual case still appears to be limited.
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M-mode and two-dimensional echocardiograms were obtained in a patient with aortic dissection (De Bakey type 1). The M-mode echocardiogram showed an image resembling to an aortic valve with a left coronary cusp and eccentric diastolic echoes. The M-mode and two-dimensional echocardiograms recorded at a more distal level showed that this image was produced by the systo-diastolic movements of the torn intima. Such an echocardiographic finding should suggest the presence of an aortic dissection.
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Serum concentrations of T4, T3, reverse T3 (rT3), TSH, Thyroxine binding globulin (TBG) and Thyroxine binding prealbumin (TBPA) were measured and a TRH-stimulation test was performed in 10 iodide untreated children affected by cystic fibrosis (CF) and in 84 controls. As compared to the controls, CF patients had lower T4 and rT3, similar T3 and TBG and increased T3:T4 ratios. They also had lower TBPA, but this could not account for the low T4. Finally they had higher basal and TRH-stimulated TSH. Our results indicate subclinical hypothyroidism in CF. The mechanisms responsible for this situation are not elucidated by our data.
Some advantages of using 3D techniques in small scale NMR imaging are suggested. In particular the 3D methods are likely to be useful in slow dynamical processes occurring in vivo. Three-dimensional images obtained with our first home built prototype are also reported.