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Biomedical subjects

F Mosca

Publications and source records attributed to F Mosca.

At least 289 records · Page 16Linked to original sources
PubMed1987

Endosonographic staging of rectal carcinoma.

Transrectal ultrasonography (US) scanning facilitates the ultrastructural differentiation of the various histologic layers of the rectal wall. In particular, the muscularis propria is represented by the 4th sonographic layer. Rectal carcinoma appears on US as a low echogenic area that suddenly interrupts the regular sequence of parietal layers. Sixty-five patients suffering with carcinoma of the lower two-thirds of the rectum underwent preoperative linear endosonography for staging. The reliability of such a method in assessing the extrarectal spread was evaluated in our study, at the end of which 55 sonographic/histologic correlations were obtained. Four false-negative and 1 false-positive determinations of the presence or absence of extrarectal spread proved that sonography has a sensitivity and specificity of 91%, with a positive predictive value of 97% and a negative predictive value of 71%. Lower results are obtained in lymph node staging: enlarged lymph nodes are seen in only 11/22 C1/C2 patients (11 false negatives) while we were aware of 3 false positives.

Adult↗
PubMed1987

A case of Dejerine-Sottas disease with prominent ataxia and brain stem involvement. A clinical, electrophysiological, otoneurologic, and ultrastructural study.

A case is presented of Dejerine-Sottas disease in a 12-year-old boy in which clinical signs made diagnosis of Friedreich's ataxia seem plausible. Based on marked slowing of motor conduction velocity, the sural nerve biopsy findings of a hypertrophic neuropathy with hypo- and demyelination of the nerve fibres, as well as the clinical history, the diagnosis of Dejerine-Sottas disease was made. ABR examination suggested involvement of brain stem at the roots and/or nuclei of the eighth cranial nerve, without involvement of higher structures.

Adolescent↗
PubMed1987

Renal scintigraphic captopril test in the diagnosis of renovascular hypertension.

Angiotensin converting enzyme (ACE) inhibitor-induced renal failure has been reported in bilateral renal artery stenosis and in stenosis in solitary kidneys, but not in unilateral renal artery stenosis. In these patients, however, a functional impairment of the kidney ipsilateral to the stenosis can often be detected after ACE inhibition by scintigraphic techniques employing glomerular radionuclide tracers like 99mTc-diethylenetriamine pentaacetic acid (DTPA). Dynamic renal scintigraphy with 99mTc-DTPA before and 1 hour after administration of captopril, 25 mg (renal scintigraphic captopril test; RSCT), was performed in a selected series of 39 hypertensive subjects with suspected renovascular hypertension. Changes in glomerular filtration rate induced by captopril on the individual kidney were estimated by assessing the early (120-180 seconds) DTPA uptake by the kidney. Values were expressed as the ratio between the kidney with the lower uptake and the contralateral one in 34 patients and as the ratio of the kidney counts to the injected dose in five patients with solitary kidneys, aortic coarctation, or both. Compared with precaptopril values, postcaptopril uptake decreased markedly in 14 subjects (-62.42 +/- 30.94 [SD]%; range, -25 to -100%) and decreased modestly or even increased in the other 25 (+0.57 +/- 9.83%; range, +28 to -13%). Of the 14 subjects considered to be RSCT-positive diagnostic workup revealed either established (10) or strongly suspected (2) renal artery stenosis in 12 and aortic coarctation in 2 subjects. In another patient with established renovascular hypertension, results of the RSCT were negative when performed in the supine position but became positive when repeated in the sitting position.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Sonographic detection of postsurgical recurrence of Crohn disease.

Sonography, contrast radiography, and endoscopy of the small and large intestine were performed in 32 patients, who had already undergone one or more intestinal resections for Crohn disease, with the aim of detecting possible relapses. Eleven patients proved to have had relapses; sonography revealed nine cases, with two false negatives and no false positives. Sensitivity proved to be 82%, specificity 100%, and overall accuracy 93.7%. Sonography enables the operator to distinguish between inflammatory and neoplastic lesions by means of structural study of the thickened bowel wall, paying particular attention to integrity of its layers.

Adult↗
PubMed1986

Otoneurological findings in Friedreich's ataxia and other inherited neuropathies.

Fifteen cases of Friedreich's ataxia (FA) were examined using an otoneurological test battery that included tone and speech audiometry, the synthetic sentence identification (SSI) test, impedance audiometry, cortical auditory-evoked response (CAER), brainstem auditory-evoked response (ABR) and electronystagmography. We also obtained ABR and CAER findings in 2 cases of familial spastic paraplegia, in 5 cases of Charcot-Marie-Tooth disease and 6 in cases of atypical FA of uncertain classification. The results of puretone and impedance audiometry were normal in all cases. ABR could not be elicited in 11 FA patients and were abnormal at higher intensity levels in the remaining 4 patients. In these 4 cases, however, the latencies were normal. ABR did not show any marked abnormalities in patients with familial spastic paraplegia or Charcot-Marie-Tooth disease. CAERs were normal in all 28 patients. ABRs tended to be absent with the progression of FA. ABR thresholds were correlated with the Inherited Ataxias Clinical Rating Scale score, which is an index of the severity of the illness. ABRs contributed to the diagnosis or to excluding FA in patients with an atypical clinical picture. The absence of ABRs and the normal latencies of the waves, when evoked, agree with the pathological finding of a reduction of fibers in the spinal root ganglion. SSI abnormalities and vestibular findings agree with this hypothesis.

Adolescent↗
PubMed1986

[Reception of adolescents at an intersector dispensary. Retrospective study of 5 years of operation].

The study of some characteristics (clinical and sociodemographic) of a population of adolescent clients and the modes of reception and therapeutic modalities which have been proposed for them introduces a discussion on: the contributions and the limits of so-called informal modes of reception and assigning to treatment, as well as the value of taking into consideration the ways the adolescents relate to their environment; the necessity for rapid agreement and the diversity of the observed evolutions which justify both the need for adequate identification of immediate movement and for a dynamic perspective; and, after considering the adequacy of the gathered information for our way of thinking and practicing, the pertinence of an epidemiological evaluation and its utility for clinicians.

Adolescent↗
PubMed1985

Ultrasound detection of unusual spontaneous portosystemic shunts associated with uncomplicated portal hypertension.

Seven cases of unusual spontaneous portosystemic shunts observed by ultrasonography in the last 8 months are reported, including cases of coronary vein varicocele and patent umbilical vein; two cases of spleno-retroperitoneal anastomosis; omphalo-ilio-caval anastomosis; superior mesenteric vein-inferior vena cava anastomosis; spleno-renal anastomosis; and spleno-portal anastomosis and anastomosis from the splenic vein to the abdominal wall. One of these collateral vessels was also analyzed by pulsed Doppler flowmetry. The patients were either cirrhotic or had pre-hepatic portal hypertension (resulting from chronic pancreatitis) and gave no history of gastrointestinal bleeding or ascites. Two of these patients had previously undergone surgery for problems associated with cholestasis. In both cases, presurgical sonographic studies were used to guide the surgical procedures in the hope of preserving the anomalous connections. Furthermore, ultrasound detection of spontaneous portosystemic shunts was an important factor in interpreting the clinical symptoms of these patients.

Adult↗
PubMed1985

Acute effect of captopril on single kidney glomerular filtration rate in arterial hypertension.

Recent studies have reported that captopril can acutely induce a marked decrease of glomerular filtration rate in kidneys affected by renal artery stenosis, an effect detectable by scintigraphic techniques. Experience which confirms and extends this observation, obtained in five patients with renovascular hypertension, is reported here. For comparison, eight essential hypertensives and six patients with non-vascular unilateral renal diseases were studied. In each patient the ratio of glomerular filtration rate between the two kidneys was estimated during two consecutive scintigraphic studies with the glomerular tracer 99mTc-DTPA: in all renovascular patients captopril induced a marked decrease of glomerular filtration rate on the affected side, whereas negligible changes were observed in all other subjects. These results confirm that captopril may almost completely suppress glomerular filtration in kidneys affected by unilateral renal artery stenosis, an effect which may not be apparent clinically because of compensation by the other kidney, but which is scintigraphically detectable. Renal scintigraphy after captopril is easy to perform and non-invasive. It therefore seems to be a promising tool for the screening of renovascular hypertension.

Captopril↗
PubMed1985

Lactose absorption and malabsorption in healthy Italian children: do the quantity of malabsorbed sugar and the small bowel transit time play roles in symptom production?

Using breath hydrogen analysis after an oral lactose load (2 g/kg; maximum 50 g), we investigated the prevalence of lactose malabsorption in 61 healthy Italian children aged 6-13 years. We also examined the relationship between symptoms and small bowel transit time and the degree of sugar malabsorption. Three of 61 subjects produced no H2 after both lactose and lactulose load and thus were eliminated at the outset. Lactose malabsorption was defined as excretion of greater than 20 ppm H2. Lactose intolerance was classified as mild (colicky pain, flatulence, abdominal distension, borborygmi) or severe (diarrhea). The frequency of lactose malabsorption in the children aged 6-8 years (group I) was 25%; in the children aged 8-11 years (group II), it was 35%, and in the children aged 11-13 years (group III) 56%. The differences in frequency between the first and the third groups were significant (p = 0.05). Three of 20 (15%) in group I, two of 20 (10%) in group II, and three of 18 (17%) in group III were classified not only as lactose malabsorbing, but also as lactose intolerant, with symptoms during and after the test. We found no difference in the small bowel transit times or in the quantities of malabsorbed lactose in symptomatic and asymptomatic malabsorbing subjects. Other factors that may play a role in symptom production are discussed.

Adolescent↗
PubMed1984

[Histochemical identification of preneoplastic hepatocellular lesions in the human liver].

The activity of gamma-glutamyltranspeptidase (GGT) as well as glycogen storage within hepatocytes from cirrhotic human liver were investigated by histochemical means. In 4 cases out of 9, many enzyme-altered, PAS positive dysplastic 'foci' were seen. Such lesions may be considered as possible precursors of hepatoma, as already reported in rat liver during chemical carcinogenesis. Among the preneoplastic liver markers, GGT positivity seems the most useful one to be added to the routine histological examination of liver biopsies.

Biopsy↗