Further studies on plasma androgens and gonadotropins after cyproterone-acetate (SH 714).
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17-Hydroxycorticosteroids↗
Biomedical subjects
F Fraioli
Publications and source records attributed to F Fraioli.
[Radioimmunoassay of gonadotropins].
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Adolescent↗
Prolactin secreting adenoma in man and the role of prolactin in spermatogenesis.
The case of a 23-year-old man with a pituitary prolactin secreting adenoma is described. With the exception of prolactin all endocrinological parameters were normal. This finding provided an ideal opportunity to assess the role of prolactin on spermatogenesis. Sperm analysis and light microscopy examination of testicular biopsy showed normal spermatogenesis. Electron microscopic studies of the testicular specimen revealed the presence of undivided spermatids, containing two or more nuclei, partially embedded in a developing common acrosome. Morphological studies demonstrated a constant "paired" situation. In most instances two sperms were contained in a single membrane; no single sperm was detected. Following treatment with 5 mg/day bromocriptine prolactin levels decreased and this peculiar abnormality disappeared. In fact, after 2 months of treatment the sperm abnormalities were markedly reduced, whereas no change was found after a period of 120 days. Since this was the only alteration found in the patient with high prolactin levels, a correlation was sought between prolactin levels and cell division. Considering the similarities between prolactin and growth hormone, it might be possible to attribute to prolactin a growth hormone role in the germinal epithelium. This action could be either direct or indirect via an intermediate growth factor.
Adenoma↗
High-resolution CT angiography of the abdomen.
Multislice computed tomographic angiography (MSCTA) is a versatile technique that combines speed, excellent contrast, superb spatial resolution, and extreme simplicity. It has a wide range of applications in the abdomen including all vascular pathologies, occlusive or dilative, with excellent demonstration of atherosclerotic plaques in large or smaller branches. MSCTA is the method of choice in the follow-up of patients undergoing endovascular procedures for aneurysms. It provides excellent results in assessing vascular involvement by neoplasms arising from the liver, biliary tract, pancreas, kidneys, and all other abdominal organs. MSCTA can be used successfully in potential living donors and in the follow-up of recipients. Although MSCTA is a brand new technique, several developments are under investigation, which should allow further advancements in speed and spatial resolution.
Abdomen↗
Increased plasma beta-endorphin levels in hereditary angioedema.
We measured beta-endorphin (BE) and beta-lipotropin (BLPH) plasma concentrations (by means of an HPLC-RIA coupled method) during attacks as well as during symptom-free periods in a group of 28 patients with immunochemical (21) or functional (7) Cl inhibitor deficiency. Thirteen patients suffering from chronic urticaria served as controls. Three orders of considerations prompted us to initiate the present study: the clinical relationship between stress and the onset of acute episodes, the possible effects of repeated stressful situations, as are the attacks themselves, on the patients' neuroendocrine system and the well-known existence of close links between the immune system and endogenous opioids. The results show that plasma BE (and, to a lesser extent, BLPH) is dramatically increased during the attacks. In symptom-free periods many patients show very high BE concentrations, often in the presence of slightly elevated concentrations of BLPH and of ACTH. These observations suggest that patients with hereditary angioneurotic edema show a modified pro-opiomelanocortin-synthesizing cell activity that can result in a massive release of BE from the readily disposable pool present in the pituitary and/or an increase in the turnover of the peptide as evaluated by the BLPH/BE ratio.
Adolescent↗
[Magnetic resonance angiography with contrast media in the study of carotid arteries].
PURPOSE: Purpose of our study was to determine the feasibility and accuracy of contrast enhanced Turbo-MRA (CE-MRA) in the evaluation of patients with carotid artery stenosis, using a dynamic technique with multiple acquisitions. MATERIAL AND METHODS: 37 patients with suspected carotid artery stenosis were studied with a 1.5 T magnet (Siemens Vision Plus) using, with a neck phased array coil, a dynamic tridimensional T1 weighted spoiled GRE (TR/TE/NEX: 3.8/1.4/1; Matrix = 110 x 160; FOV = 163 x 260 mm TA = 10 seconds for each sequence); 4 consecutive sequences were performed during the same breath hold, acquired after i.v. bolus injection with a power injector (Spectris, Medrad) of 15 ml of Gd-DTPA followed by 10 ml of saline solution (flow rate 2 ml/s). The beginning of the sequence coincided with the injection of Gd-DTPA. Images were reconstructed using a standard MIP algorithm, by selecting which of the sequences provided the highest enhancement. In all patients a DSA was also performed. Images were separately evaluated using conventional angiography as the gold standard and assessed for degree of stenosis by using NASCET criteria, and morphology of the plaque. RESULTS: CE-MRA correctly evaluated the degree of stenosis in 71 of the 74 patients, while overestimated the remaining 3 cases correctly evaluated by DSA. In 12 cases ulcerations were adequately demonstrated by one of the radiologist, while 11 on 12 were depicted by the other one. CE MRA allowed to detect tandem lesions of the internal carotid arteries (by both radiologists) in 13 of 74 carotids studied. Stenosis at the origin of the common carotid arteries were correctly detected in 9 cases. Sensitivity, specificity and accuracy were respectively of 98, 97 and 99%. DISCUSSION AND CONCLUSIONS: In order to perform an optimal CE-MRA a dynamic technique must be performed to avoid venous filling. The possibility to use ultrafast imaging allows to selectively image the carotid arteries without jugular filling. The well known tendency to overestimate the degree of stenosis has not been found in this group of patients. CE-MRA is a rapid, reliable method to evaluate patients with suspected carotid artery stenosis. These results allow to consider dynamic CE-MRA as a valid method for direct imaging of the carotid arteries.
Carotid Stenosis↗
[Inflammatory markers after laparoscopy versus laparotomy cholecystectomy].
OBJECTIVE: The study is carried out to determine whether the level of IL-6 is altered and in what way after surgery as well as if such a change could be an indicator of increased morbidity after surgical treatment. MATERIALS OF THE STUDY: Chemiluminesence immunoeassay system was used in order to establish IL-6 level in blood samples of 71 patients that underwent abdominal surgery, 36 Laparoscopic Cholecystectomy (LC) and 35 Open Cholecystectomy (OC) at time 0 (before the operation), 1 h, 2 h, 3 h, 6 h, 24 h and 48 h after the operation. RESULTS: Plasma IL-6 levels are significantly increased after OC; we observed 3 cases of post-operative infections, in which IL-6 returned to normal levels 6 days after surgery. Analogous variation to the IL-6 levels was noted for the C-reactive protein levels. DISCUSSION: Laparoscopic cholecystectomy, a so called mini-invasive surgical procedure, is associated to a small increase of IL-6 serum levels and provides better post-operative conditions to the patients by reducing surgical stress and the infectious complications correlated to the surgical procedure. CONCLUSIONS: During OC there is a significant higher elevation of IL-6 serum levels than after laparoscopic cholecystectomy. Variation of C-reactive protein serum levels after surgery is analogous to variation of IL-6 levels.
Adult↗
Evaluation of effectiveness of a computer system (CAD) in the identification of lung nodules with low-dose MSCT: scanning technique and preliminary results.
PURPOSE: Evaluation of the effectiveness of computer-aided diagnosis (CAD) in the identification of pulmonary nodules. MATERIALS AND METHODS: Two observers (A1, A2) with different levels of experience independently evaluated 20 chest MSCT studies with and without the aid of a CAD system (LungCheck, R2 Technology, Inc). The study parameters were as follows: 140 kVs, 40 mAs, collimation 4 x 1 mm, slice thickness 1.25 mm, reconstruction interval 1.0 mm. The observers analysed the images with and without CAD and evaluated: 1) nodule size (longer axis); 2) number and location of nodules; 3) reading time for each observer. The gold standard was represented by the evaluation of both readers in consensus with the aid of the CAD system. RESULTS: Without CAD support the two readers identified 77 (A1) and 79 (A2) nodules and with CAD 81 (A1) and 82 (A2) nodules. Working in consensus the two observers identified 81 nodules without the aid of the CAD and 84 nodules with the aid of CAD. Total number of nodules identified by CAD was 104, 25 of which were false positive and 5 false negative. The average reading time with the aid of the CAD decreased by as much as 40% for both the observers. CONCLUSIONS: The preliminary results of our study suggest that the CAD technique is an accurate automatic support tool in the identification of pulmonary nodules. It reduces reading time and automatically supplies the size, volume, density and number of nodules, thus being useful both in screening programmes and in the follow-up of cancer patients, in whom comparison of the images is particularly difficult.
Adult↗
[Usefulness of spiral CT in the prevention of pulmonary barotrauma: presentation of a case report in a hyperbaric operator].
A medical surveillance integrated system for health care workers, engaged in an hyperbaric environment exposure, was set upped and implemented in an university hospital, in accordance with doctrinal, legislative and methodological issues. In particular, a specific attention on anatomic and functional assessment of the respiratory system was applied, through an advanced technique of spiral-CT imaging, with the aim to carry out an early detection of conditions to be predispose "pulmonary barotrauma". Therefore, the present contribution proposes to illustrate clinical and instrumental data, and also to show chest spiral-CT acquired images results, in a 35-years-old nurse on assignment to an hyperbaric oxygen therapy unit. In this experience the described preventive protocol was operated in the context of a modern rational and justifiable, flexible and balanced health protection path.
Adult↗
[ACTH and cortisol serum level in women with glaucoma simplex].
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Adrenocorticotropic Hormone↗
[Prophylaxis with cefazolin in surgery of the hip (author's transl)].
Our study shows that prophylactic use of an adequate antibiotic appears to be warranted in osteoarticular surgery, during the immediate pre and post-operative periods. The mechanism by which this prophylaxis is effective remains under debate. Surgeons should be encouraged to abandon the use of wide-spectrum antibiotics or combinations of several antibiotics for prophylactic purposes. The only useful prophylaxis is the prescription of one antibiotic effective against the most common agent i.e. staphylococcus aureus. Our results suggest an early action of the antibiotic, as soon as the leukocytes and microorganisms make contact. Selection of highly resistant microorganisms by polyvalent antibiotic therapy is precluded by the prophylactic regimen advocated here. Use of cefazolin during a very short period appears to be a satisfactory solution to prophylactic problems in osteoarticular surgery.
Adult↗
Hormonal regulation of bicarbonate secretion in the biliary epithelium.
Bicarbonate excretion in bile is a major function of the biliary epithelium. It is driven by the apically located Cl-/HCO3- exchanger which is functionally coupled with a cAMP-dependent Cl- channel (CFTR). A number of hormones and/or neuropeptides with different mechanisms and at different intracellular levels regulate, in concert, the processes underlying bicarbonate excretion in the biliary epithelium. Secretin induces a bicarbonate rich choleresis by stimulating the activity of the Cl-/HCO3- exchanger by cAMP and protein kinase A mediated phosphorylation of CFTR regulatory domain. Protein phosphatase 1/2A are involved in the run-down of secretory stimulus after secretin removal. Acetylcholine potentiates secretin-choleresis by inducing a Ca(++)-calcineurin mediated "sensitization" of adenyl cyclase to secretin. Bombesin and vasoactive intestinal peptide also enhance the Cl-/HCO3- exchanger activity, but the intracellular signal transduction pathway has not yet been defined. Somatostatin and gastrin inhibit basal and/or secretin-stimulated bicarbonate excretion by down-regulating the secretin receptor and decreasing cAMP intracellular levels induced by secretin.
Adenylyl Cyclases↗