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Biomedical subjects

F Scopinaro

Publications and source records attributed to F Scopinaro.

At least 73 records · Page 4Linked to original sources
PubMed1995

Sestamibi imaging and echocardiography: a combined approach to myocardial infarction.

The resting relationship of MIBI segmental uptake to regional wall motion has been studied in 30 patients with postinfarction wall motion abnormalities. The purpose of this study was to verify whether an integrated approach using Sestamibi (MIBI) imaging (perfusion analysis) combined with echocardiography (ECHO) (wall motion analysis) could present an additive value to differentiate infarcted from viable myocardial areas with respect to MIBI imaging alone. The same 11 segments model for left ventricle was used to compare segmental wall motion scores versus segmental uptake scores using a chi 2 analysis. The global score frequency rates for MIBI and ECHO were examined and a subsequent comparative analysis score versus score on each segment was performed. Our data, based on a chi 2 analysis, indicated that MIBI imaging overestimates the effective area of necrosis, underestimating, furthermore, hypoperfused but non-necrotic myocardium. We can conclude that an integrated approach based on both segmental perfusion and wall motion analysis, seems to be clinically suitable for a correct evaluation of infarcted patients, especially in view of revascularization procedures, providing an additive value in discriminative capacity, with respect to MIBI scintigraphic analysis alone.

Echocardiography↗
PubMed1994

Technetium-99m sestamibi: an indicator of breast cancer invasiveness.

As recently shown, angiogenesis is the most reliable marker of breast cancer invasiveness. Unfortunately it must be assessed by immunohistochemistry on tissue specimens. We have used technetium-99m sestamibi, a marker of regional blood flow in other organs that often but not always images breast cancer, to assess the invasiveness of this tumour. Nineteen patients, ten with nodal metastases and nine without any metastases, were studied with 99mTc-sestamibi scintigraphy before operation. Angiogenesis was quantitatively assessed by immunohistochemical staining of endothelia for factor VIII. All the node-positive (N+) patients at surgical revision showed a positive 99mTc-sestamibi scan of the primary tumour and all the N-patients were negative. Nine out of ten N+ and sestamibi-positive tumours showed more than 135 microvessels/mm2 and one showed 99 microvessels/mm2; by contrast there were 71.6 +/- 12.1 microvessels/mm2 in the nine N- and sestamibi-negative tumours. Our study suggests that 99mTc-sestamibi is a marker of breast cancer invasiveness: its uptake is related to angiogenesis and, possibly, to oxidative metabolism of the tumour.

Adult↗
PubMed1994

Hepatoduodenal bile transit in cholecystectomized subjects. Relationship with sphincter of Oddi function and diagnostic value.

The hepatic hilum-duodenum transit time (HHDT) was evaluated in cholecystectomized subjects to assess its relationship with the motor function of the sphincter of Oddi (SO) and its diagnostic accuracy in the detection of SO dysfunction. The study was performed in asymptomatic controls and symptomatic patients with SO dysfunction before and after sphincterotomy. HHDT showed a direct correlation with manometric SO maximal basal pressure (r = 0.77; P < 0.001) but not with SO phasic activity. In sphincterotomized subjects HHDT did not differ from that of the asymptomatic subjects, and HHDT, which was prolonged before sphincterotomy, normalized after sphincterotomy. HHDT had a 100% specificity and an 83% sensitivity in diagnosing SO dysfunction when compared to SO manometry. In conclusion, the cholescintigraphic HHDT is mainly related to the SO maximal basal pressure, presenting an elevated specificity and a satisfactory sensitivity in the diagnosis of SO dysfunction in cholecystectomized subjects.

Adult↗
PubMed1994

Identification of viable myocardium in patients with chronic coronary artery disease and left ventricular dysfunction: role of magnetic resonance imaging.

Nineteen patients (16 men and 3 women, mean age 51 years) with previous anterior myocardial infarction and severe stenosis (> or = 90%) of the left anterior descending coronary artery were studied by magnetic resonance imaging (MRI) without and with contrast media to verify the capability of MRI in identifying viable myocardium in areas of severe systolic dysfunction. In corresponding left ventricular segments, a comparison was made between regional signal intensities (SI) determined on MRI images before and 4, 8, 12, and 30 minutes after administration of paramagnetic contrast media (gadolinium diethylenetriaminepentaacetic acid, 0.4 mmol/kg intravenously) and metabolic parameters determined by iodine 123 phenylpentadecanoic acid (IPPA) scintigraphy. The SI and the time of maximum postcontrast enhancement were analyzed by dividing the left ventricle into 11 segments. Each segment was classified as normal (group 1, n = 116), hibernating (group 2, n = 50), or necrotic (group 3, n = 43) on the basis of the IPPA washout rate (> 30%, 10% to 30%, and < 10%, respectively). Regional SI demonstrated significant differences in absolute values at 12 minutes (group 3: 1.62 +/- 0.58 vs group 1: 1.32 +/- 0.52, p < 0.01, and vs group 2: 1.34 +/- 0.48, p < 0.05) and at 30 minutes (group 3: 1.71 +/- 0.47 vs group 1: 1.21 +/- 0.55, p < 0.01, and vs group 2: 1.49 +/- 0.57, p < 0.05) and in temporal distribution. These results suggest that MRI has a potential role in differentiating viable from necrotic myocardium in patients with chronic severe systolic dysfunction.

Contrast Media↗
PubMed1994

99Tcm-MIBI uptake in green plants.

Uptake of 99mTcm-sestamibi by biological structures depends on delivery and concentration by electrochemical gradients through the biological membranes and can be simply studied using a green plant model in which photosynthesis tightly modulates water and solute regional flow. Photosynthesis creates electrochemical gradients inside chloroplasts and mitochondria. Moreover, it is the driving force for the movement of water and solutes through induction of pore opening which causes capture of CO2 and loss of water vapour. Thus osmotic pressure increases thereby drawing water from the roots. Hypoestes sanguinolenta was used as an experimental model. This plant displays green zones (with several chloroplasts) and red zones (where they are absent). To detect the uptake differences between these zones we used a new, high-resolution gamma camera. Our results show that (a) 99mTcm-sestamibi is actively transported with water and ions by xylem to leaves where it may diffuse at cellular levels; (b) activation of photosynthesis by light strongly influences the total uptake and the selective compartmentation in green zones; and (c) the green plant's particular physiology tremendously enhances the differences between 99Tcm-sestamibi and 201Tl uptake. We suggest that viable cells, able to create and maintain electrochemical gradients, selectively take up 99Tcm-sestamibi.

Biological Transport↗
PubMed1994

Characterization of reversible myocardial dysfunction by magnetic resonance imaging.

Some recent cardiovascular applications of nuclear magnetic resonance imaging (MRI) are discussed, on the basis of both literature and personal data. Management of coronary patients has become directed to strategies aiming at salvaging the ischemic myocardium, and MRI can play an important role in providing the necessary data leading to an appropriate assessment. Due to its capability in showing morphofunctional information on wall thickness and thickening, cine-MRI technique can be used to detect myocardial ischemia and infarction, since it allows the acquisition of 16 or more frames of the cardiac cycle which can be displayed in a cine loop format. In an Italian Cooperative Study the role of MRI in discriminating stunned from necrotic areas has been investigated. Comparison of fractional area change by echo versus cine-MR turned out to be almost completely overlapping, but cine-MRI allowed a more accurate measurement of systolic wall thickening due to better visualization of endo- and epicardial borders (more sensitive marker of kinetic damage than wall motion). Other studies have also been performed in order to determine the capability of contrast agents of allowing differentiation between reperfused reversible and irreversible myocardial injury and allowing distinction between reperfused and occlusive myocardial infarction. In a recent study we investigated the MRI possibility of identifying viable myocardium in severely chronic systolic dysfunctioning areas by comparing, in corresponding left ventricular segments, regional perfusion and metabolism at IPPA scintigraphy and regional signal intensity at MR images obtained before and after paramagnetic contrast media administration. The potential role of MRI was shown in the identification of viable myocardium with the use of contrast medium, that is of crucial importance in this respect.

Diagnosis, Differential↗
PubMed1994

Circulating D dimer in inflammatory bowel disease.

An activated thrombogenesis has been reported in inflammatory bowel disease (IBD). In this study we evaluated whether a fibrin degradation product, the D dimer, is increased in patients with IBD. D dimer plasma levels were evaluated by sandwich ELISA in patients with Crohn's disease (24), ulcerative colitis (25), gastrointestinal (GI) disease controls (10), hospital controls (13) and healthy subjects (14). Circulating D dimer was significantly higher in ulcerative colitis (median 651; 95% CI 89-1275 ng/ml) than in healthy subjects (median 412; 95% CI 112-672 ng/ml; p = 0.002), Crohn's disease (median 466; 95% CI 6-931 ng/ml; p = 0.005) and GI disease controls (median 446; 95% CI 196-688 ng/ml; p = 0.023). In ulcerative colitis, plasma D dimer was related to inflammatory parameters such as C-reactive protein (p < 0.01) and seromucoids (p < 0.001). Circulating D dimer was age-related in all groups (p < 0.05). Fibrin degradation, as reflected by plasma D dimer, is detected in patients with ulcerative colitis exhibiting a marked acute phase response.

Adult↗
PubMed1993

Radioisotope assessment of heart damage in hypertransfused thalassaemic patients.

Twenty-five thalassaemic patients treated with repeated blood transfusion (BT) and intensive iron removal therapy were studied by echocardiography and rest/stress equilibrium gated radionuclide angiocardiography (EGNA). Stress left ventricular ejection fraction (LVEF) showed an important negative correlation with number of BTs (r = -0.75). Abnormal values of stress LVEF were measured after 200 BTs: these data demonstrate the effectiveness of stress LVEF in the follow-up of patients who have undergone repeated BTs and the clinical importance of intensive chelation therapy. Peak filling rate did not show diagnostic value in the early detection of iron cardiotoxicity. However, its inverse correlation with BT (r = -60) indicates that iron overload depresses the diastolic parameters.

Adolescent↗
PubMed1993

[Imaging in atherosclerosis: scintigraphy techniques].

Noninvasive detection of atherosclerotic plaques remains a major challenge for clinical diagnosis, therapy and prognosis. Several approaches have been explored as a tool for thrombus imaging, using platelets, antiplatelet antibodies and fibronectin or as a direct metabolic marker as low density lipoproteins or photophrine II. We tested the affinity of a new F(ab')2 monoclonal antibody (TRF1) against human fragment D-dimer of cross-linked fibrin, for atherosclerotic plaques free of detectable thrombi on their surface. Six atherosclerotic segments of carotid and femoral arteries, and (as a control) 5 segments of atherosclerosis-free internal mammary artery, were drawn from 11 male patients undergoing bypass surgery. All segments were carefully washed in order to dissolve and remove possible endoluminal thrombi, and were subsequently cut to obtain couples of fragments of intima of similar weight, containing atherosclerotic plaques (n 16), or fatty streaks (n 12), or normal endothelium (n 20). Each fragment was separately put into a radioimmunoassay vial, and underwent a direct binding test to TRF1, or to an aspecific antibody, which both were labelled with 125I. The activity present in each fragment was measured with a gamma-counter after 3 h of incubation at 37 degrees C, and every hour after washing the fragments in order to remove the unbound antibody. No significant binding difference (expressed as per cent final activity in comparison with initial one) of the aspecific antibody between normal and atherosclerotic fragments was found. By contrast, TRF1 binding was significantly higher (p < 0.001) in atherosclerotic than in normal fragments (26.0 +/- 11.5% in atherosclerotic plaques, versus 9.23 +/- 9% in fatty streaks, versus 1.9 +/- 0.6% in normal endothelium.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗
PubMed1992

Anti D dimer monoclonal antibodies: a possible scintigraphic agent for immunodetection of thrombi.

The aim of this work was to produce a MoAb able to react with clots but not with fibrinogen. Monoclonal antibodies directed towards DD dimers, against specific products of plasmic digestion of cross-linked fibrin, were obtained. One of these antibodies, F 60/43/8, showed a 1.79 x 10(9) l mol-1 binding constant in spite of the presence of fibrinogen at a 4000 times greater concentration than the cross-linked fibrin. In vitro studies with 125I-F(ab')2 of F 60/43/8 showed that 34-80% of the radioactivity can be found in human clots, in the presence of physiologic concentrations of fibrinogen, and that 96-h washing does not remove the labelled F(ab')2 from the clot. 131I-F(ab')2 was injected into rabbits in which a clot had formed in an artery (six rabbits) or in a vein (six rabbits) of the left ear. Scintigraphic images of the clot were always obtained. In conclusion, the results of this work suggest that F 60/43/8 may be used as a specific antibody for the radioimmunodetection of thrombi.

Animals↗
PubMed1991

Quantitative cholescintigraphy in the assessment of choledochoduodenal bile flow.

Quantitative cholescintigraphy has been proposed as a noninvasive method to assess function of the sphincter of Oddi in cholecystectomized subjects. The present study evaluated several quantitative cholescintigraphic variables to assess their time-related variability as well as their capability to detect delay of choledochoduodenal bile flow. Cholescintigraphy with 2,6-diethylphenylcarbahoylmethyl diacetic acid 99mTc was performed in 24 cholecystectomized patients with recurrent biliary-like pain, laboratory evidence of bile stasis, normal hepatocellular function tests, and no evidence of choledocholithiasis. The study was also performed in 26 asymptomatic cholecystectomized subjects and repeated at 2-week intervals during identical experimental conditions in 10 of them. Of the following quantitative cholescintigraphic variables investigated, (a) hepatic T peak, (b) 50% hepatic retention (T peak, 1/2), (c) percent hepatic retention at 30 minutes, (d) percent hepatic retention at 40 minutes, (e) vein-hepatic hilum transit time, (f) vein-duodenum transit time, and (g) hepatic hilum-duodenum transit time, only the hepatic hilum-duodenum transit time showed a statistically significant correlation between the duplicate studies. Only vein-duodenum transit time and hepatic hilum-duodenum transit time discriminated the symptomatic from the asymptomatic patients; of the two variables, however, hepatic hilum-duodenum transit time showed less intrasubject variability and no overlap between the two groups of patients. Hepatic hilum-duodenum transit time showed a positive linear correlation with the maximum diameter of the choledochus. It is concluded that in cholecystectomized patients, the hepatic hilum-duodenum transit time appears to detect a delay of bile flow into the intestine better than any other cholescintigraphic variable. However, in patients with a dilated common bile duct, this variable cannot discriminate bile flow delay due to increased choledochal capacity and/or obstruction of the sphincter of Oddi.

Adult↗
PubMed1990

Fibrodysplasia ossificans progressiva. An 11-year-old boy treated with a diphosphonate.

Fibrodysplasia ossificans progressiva (FOP) is a severe, rare, autosomal dominant, ectopic ossifying condition, with primary involvement of the skeletal muscles associated with skeletal abnormalities. This report concerns an 11-year-old boy suffering from FOP, who presented significant modification of the musculoskeletal structure of the thorax and problems with articular movements. The patient showed progress after treatment with ethane-1-hydroxy-1,1-diphosphonate (EHDP). In fact, using a scintiscanner we were able to observe a significant improvement in symptoms and a recovery of some of the active sites of ossification.

Child↗
PubMed1990

[Echocardiokimography and scintigraphy with Tc-MIBI in left ventricular asynergy in chronic myocardial infarct. Comparison of these methods].

The study compared echocardiography, specially echocardiokimography, and myocardial scintigraphy in the evaluation of the extent of chronic myocardial infarction. Eighteen subjects were enrolled and the following examinations performed: ECG, M- and B-mode echocardiography, echocardiokimography and myocardial scintigraphy with Tc-MIBI, a new perfusion radionuclide agent. We concluded: 1) accordance between the two kinds of methods; 2) specificity of echocardiokimography; 3) advantage in using both methods, specially with MIBI scintigraphy.

Adult↗
PubMed1989

Right colonic hemangioma diagnosed by scintigraphy with 99-mTc sucralfate. A case report.

99-mTc-SF gastrointestinal scintigraphy used in recent years in the assessment of site and activity for ulcerative lesions, was shown to be very important for the diagnosis of a rare case of right colonic hemangioma. A young female patient suffering for some time from functional intestinal disorders, following negative radiologic and endoscopic findings, underwent 99-mTc-SF scintigraphy, which showed massive uptake of radioactivity in the ascending and right flexure of colon. A repeated colonoscopy with biopsy allowed the histologic diagnosis of capillary hemangioma.

Adult↗
PubMed1989

Myocardial ischemia during stroke: scintigraphic demonstration.

In a 74-year old female, admitted to the Acute Stroke Unit for a cerebral reversible ischemic attack, we investigated the occurrence of ischemic alterations on ECG, recorded during an acute relapse, using 99mTc (MIBI) myocardial scintigraphy. Scintigrams showed a transient anteroseptal and inferior hypoperfusion. This is the first direct demonstration of myocardial ischemia occurring during stroke.

Aged↗