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Biomedical subjects

G Caputo

Publications and source records attributed to G Caputo.

At least 19 recordsLinked to original sources

Deep burn of the hands: Early surgical treatment avoids the need for late revisions?

An eight years experience in the management of deep hand burns is presented. We reviewed 116 cases of patients surgically treated with escarectomy and skin autograft. Seventy eight of them underwent early surgery within the first 4-6 days from injury, while 38 were conservatively treated in the fist stage and only lately surgery was performed (usually after the 14th day). In all patients, we applied the same post operative topic treatment and rehabilitation protocol. Several months after first admission, only 6(7.7%) of early treated patients needed secondary correction for unaesthetic and functionally debilitating scars versus 14(36.8%) of the late treated group. Our review confirm the importance of performing early surgery of deep burns of the hands, whenever possible, in order to achieve best results and shows it's utility in reducing re-admissions for secondary revisions.

Adolescent↗

[Iris mammillations: three case reports].

INTRODUCTION: Iris mammillations are congenital abnormalities characterized by vitiliform protuberances regularly spaced on the surface of a velvety iris. They can be either isolated or associated with melanocytosis involving iris, sclera or periocular tissues, resulting in a risk for uveal melanoma. They can be complicated by ocular hypertension. We report three cases of iris mammillations in three children. CASES REPORT: For each patient, age, circumstances of revelation, anterior and posterior segment examination, intraocular pressure, associated anomalies, and progression were noted. Patient no. 1: In a 13-month-old boy examined for a squint, bilateral iris mammillations were fortuitously discovered. Intraocular pressure remained normal over 22 months of follow-up. Patient no. 2: In an eight-year-old boy, bilateral iris mammillations with papillary excavation were fortuitously discovered. Intraocular pressure was normal and the excavation did not change over 20 months of follow-up. Patient no. 3: A five-year-old boy was examined for a scleral pigmentation in the right eye. The examination found unilateral iris mammillations and ipsilateral ocular melanocytosis. Intraocular pressure and fundus were normal and remained normal over 13 months of follow-up. DISCUSSION: and conclusion: Iris mammillations are congenital abnormalities, generally unilateral, sometimes hereditary. The differential diagnosis includes Lisch nodules of neurofibromatosis and iris melanoma. The etiology of iris mammillations is unknown; these lesions can be complicated by ocular hypertony and, in case of associated melanocytosis of the iris, sclera or periocular tissues, by uveal melanoma. These potential complications warrant a regular clinical follow-up.

Child↗

Clinical and therapeutic experience in twenty eight patients with burning mouth syndrome.

AIM: Burning mouth syndrome (BMS) is a chronic painful syndrome in clinically normal oral mucosa. There are many local, systemic and/or psychogenic pathological conditions that may clinically appear as burning and painful sensation of the oral mucosa. There are essential or idiopathic BMS and organic or secondary BMS. A diagnostic and therapeutic protocol is proposed by the authors evaluating, the effectiveness of the estroprogestinic replacement therapy in post-menopausal women suffering from idiopathic BMS. METHODS: A total of 28 patients suffering from persistent burning and painful oral sensation underwent to careful clinical and laboratory examination in order to distinguish primary forms from secondary ones. Patients suffering from primary BMS underwent to incisional biopsy for the research of estrogens receptors. RESULTS: Only 8 out of the 28 studied patients (28.5%) were negative to the clinical oral and laboratory examinations listed in our protocol and they were diagnosed for primary BMS. All of them were females. CONCLUSIONS: The use of a valid diagnostic and therapeutic protocol allows a better management of patients suffering from oral pain and a reduction if not a disappearance of the burning symptomatology in most of them. In post-menopausal patients suffering from idiopathic BMS good results may be obtained by an estroprogestinic replacement therapy.

Adult↗

Desmin-free cardiomyocytes and myocardial dysfunction in end stage heart failure.

Our aim was to evaluate the desmin content in the myocardial tissue of patients with end-stage heart failure of ischaemic origin and to assess its role on cardiac function. We studied 18 explanted hearts from patients transplanted for end-stage heart failure due to ischaemic cardiomyopathy (ICM). Control myocardial tissue was obtained from the cardiac biopsies of six women with breast cancer taken prior to commencing chemotherapy with anthracyclines, four male donors for heart transplantation and two autoptic hearts from patients who died due to non-cardiac events. Myocardial tissue, obtained from the left ventricle (remote zone from infarcted area), was analyzed by light and confocal immunochemistry (desmin) microscopy. The desmin content of myocardial tissue was obtained by real-time PCR. Cardiac function was evaluated by echocardiographic and right heart catheterization data, obtained before heart transplantation. Confocal microscopy evaluation showed a significant decrease in the number of desmin-positive myocytes (P<0.01) in ICM hearts compared to controls. At real-time PCR evaluation, there was a reduction (P<0.01) in desmin content in the ICM patients compared to controls. A negative correlation was found between desmin-free cardiomyocytes and ejection fraction (EF) (r=-0.834; P<0.02) on echocardiogram. A negative relationship (r=-0.688) was also found between desmin-negative myocytes and capillary wedge pressure. In conclusion, the myocardial tissue of patients with end-stage heart failure of ischaemic origin, shows a decreased number in desmin-positive myocytes at immunochemistry evaluation compared to normal individuals. This deficiency in cytoskeletal intermediate filament content is associated with reduced cardiac function.

Cardiomyopathy, Dilated↗

Discrimination of an orientation difference in dynamic textures.

We investigated whether the response of a motion sensor was related to the specificity of sensory information (orientation and direction of motion) used to compute motion energy. This was done in two ways. First, we assessed whether orientation discrimination of a target line, which segregated by an orientation difference from a textured background, was improved with two-frame apparent motion stimulation (as compared with static presentation). Second, we investigated whether the amount of improvement (in either orientation or direction of motion discrimination) depends on a particular combination of target orientation and direction of motion (either orthogonal or parallel). We found that the percentage of correct responses in the discrimination task (a) was higher for a moving target than for a static one; (b) was higher when the target was oriented more orthogonally to motion direction than background elements; (c) was little affected by background motion and (d) decreased with frame duration in the direction of motion task whereas it was largely unaffected by frame duration in the discrimination of orientation task. These results suggest that discrimination of moving texture boundaries is based on a motion sensor tuned to a particular combination of orientation and direction of motion, which is capable of signalling the orientation of a moving target more accurately than a static sensor.

Analysis of Variance↗

The glare effect and the perception of luminosity.

The impression of self-luminosity in the glare effect was studied in two experiments. In experiment 1 the target (CS) was set to the highest luminance of the field and subjects were asked to adjust the luminance ramp of the inducers (R) against five backgrounds (B) to the point where they began to see CS as self-luminous. It was found that there is a linear relationship between background and luminance ramp. Another group of subjects carried out the same task in experiment 2, but this time CS and R were linked together so that CS would always have the same luminance as the highest luminance level of R, as adjustments were performed. It was found that: (i) adjustments were always lower than the highest luminance available; (ii) the linear relationship between background and luminance ramp was confirmed; (iii) observers reported a compelling impression of self-luminous grays. Data are discussed in relation to Bonato and Gilchrist's model for the perception of luminosity. The authors advance the hypothesis that luminance ramps are used at an early stage of encoding for the perception of luminosity.

Contrast Sensitivity↗

[Intraocular lens implantation in the first year of life].

We evaluated 36 eyes in 23 infants between one and eleven months old who had primary posterior chamber intraocular lens implantation for congenital cataracts. All eyes had a capsulorhexis of anterior and posterior capsulae and anterior vitrectomy. In order to obtain an emmetropia at age 5 years, we chose a 35% undercorrection of lens power for infants less than six months old, and 25% for infants between seven and eleven months old. The average follow-up was 15.3 months. Nine eyes developed posterior synechiae and eight developed a posterior opacification. The average postoperative refraction was +5.81 dioptries at one month, +4.56 at four months, +1.5, at one year, and +0.19 at two years. There was a marked subjective visual improvement in 34 eyes.

Cataract↗

Positron emission tomography with f18-fluorodeoxyglucose in the staging and preoperative evaluation of malignant pleural mesothelioma.

OBJECTIVES: The purpose of this study was to evaluate the utility of positron emission tomography with F18-fluorodeoxyglucose in the preoperative evaluation and staging of malignant mesothelioma in patients who were candidates for aggressive combined modality therapy. METHODS: Eighteen consecutive patients with biopsy-proven malignant mesothelioma underwent positron emission tomographic scanning. The results of positron emission tomographic imaging were compared with results obtained by computed tomography, mediastinoscopy, thoracoscopy, and pathologic examination of surgical specimens. All patients fasted and received an average of 14.5 +/- 2.7 mCi of F18-fluorodeoxyglucose for positron emission tomographic scanning. Attenuation-corrected whole-body and regional emission images of the chest and upper abdomen were acquired and formatted into transaxial, coronal, and sagittal images. RESULTS: All primary malignant mesotheliomas accumulated F18-fluorodeoxyglucose, and the mean standardized uptake value was 7. 6 (range, 3.33-14.85; n = 9). There were no false-negative results of positron emission tomography. Identification of occult extrathoracic metastases by positron emission tomography was the basis for excluding two patients from surgical therapy. There were two false-positive results of positron emission tomography: increased F18-fluorodeoxyglucose uptake in the contralateral chest that was negative by thoracoscopic biopsy (n = 1) and increased abdominal F18-fluorodeoxyglucose uptake after partial colectomy for diverticular disease (n = 1). CONCLUSIONS: Positron emission tomography can identify malignant pleural mesothelioma and appears to be a useful noninvasive staging modality for patients being considered for aggressive combined modality therapy.

Adult↗

Changes in myocardial cytoskeletal intermediate filaments and myocyte contractile dysfunction in dilated cardiomyopathy: an in vivo study in humans.

AIM: To investigate in vivo the intermediate cytoskeletal filaments desmin and vimentin in myocardial tissues from patients with dilated cardiomyopathy, and to determine whether alterations in these proteins are associated with impaired contractility. METHODS: Endomyocardial biopsies were performed in 12 patients with dilated cardiomyopathy and in 12 controls (six women with breast cancer before anthracycline chemotherapy and six male donors for heart transplantation). Biopsy specimens were analysed by light microscopy and immunochemistry (desmin, vimentin). Myocyte contractile protein function was evaluated by the actin-myosin in vitro motility assay. Left ventricular ejection fraction was assessed by echocardiography and radionuclide ventriculography. RESULTS: Patients with dilated cardiomyopathy had a greater cardiomyocyte diameter than controls (p < 0.01). The increase in cell size was associated with a reduction in contractile function, as assessed by actin-myosin motility (r = -0.643; p < 0.01). Quantitative immunochemistry showed increased desmin and vimentin contents (p < 0.01), and the desmin distribution was disturbed in cardiomyopathy. There was a linear relation between desmin distribution and actin-myosin sliding in vitro (r = 0.853; p < 0.01) and an inverse correlation between desmin content and ejection fraction (r = -0.773; p < 0.02). Negative correlations were also found between myocardial vimentin content and the actin-myosin sliding rate (r = -0.74; p < 0.02) and left ventricular ejection fraction (r = -0.68; p < 0.01). CONCLUSIONS: Compared with normal individuals, the myocardial tissue of patients with dilated cardiomyopathy shows alterations of cytoskeletal intermediate filament distribution and content associated with reduced myocyte contraction.

Actins↗

Amodal completion in texture visual evoked potentials.

Amodal completion refers to the phenomenological finding of perceiving partly occluded objects as continuing uninterrupted behind an occluder. The outlying problem is how the visual system processes such non-local stimuli because the known processes of early vision are spatially restricted operations which segregate local differences in the visual image, and little is known about their interactions in producing the segmentation of the image into functionally coherent, or global, objects. We recorded human visual evoked potentials (VEPs) to texture stimuli and addressed local/non-local relationships in comparing a condition in which local edges were present, due to texture segregation, with a condition in which, in addition to local edges, textures appeared to continue as surfaces behind gray stripes due to non-local amodal completion. Subtraction of offset from onset responses showed: (1) a difference component due to texture segregation characterized by a negativity with onset at about 95 ms and lasting up to about 280 ms; (2) a further negativity, specifically elicited by amodal completion, with onset at about 142 ms, peaking at 175 ms, and lasting up to about 188 ms. Therefore, amodal completion occurs at an early processing stage of image analysis and the difference component in VEPs can be related to figure-ground perception.

Adult↗

A visual evoked potential correlate of global figure-ground segmentation.

Human observers discriminated the global orientation of a texture-defined figure which segregated from a texture surround. Global figure discriminability was manipulated through within-figure collinearity, figure-surround interaction, and figure connectedness, while the local orientation contrast at edges between figure and surround was kept constant throughout all the experiments. Visual evoked potentials (VEPs) were recorded during onset-offset stimulation in which the figure cyclically appeared and disappeared from a uniform texture background. A difference component was obtained by subtraction of offset-from onset-VEP. Two negative peaks of the difference component are found with latencies around 140-160 and 200-260 ms, respectively. Enhanced discriminability of the global figure reduced (11-25 ms) the latency of the second peak, hence indicating that the 200-260 ms component was produced by global figure-ground segmentation.

Adult↗

Edge detection and surface 'filling in' as shown by texture visual evoked potentials.

OBJECTIVES: We designed a stimulation paradigm that was designed to ascertain whether specific components of the texture visual evoked potentials were attributable to edge detection or to surface 'filling-in' processes. METHODS: The stimuli were textures of parallel line elements, which were either uniform (all horizontal or vertical lines) or segregated (checkerboards in which texture line elements of neighbor checks were oriented orthogonally). A sequence of 4 stimuli, two uniform followed by two segregated stimuli, was repeated cyclically. Accordingly, segregation could appear from a uniform display; it could also be maintained, with the checkerboard illusory margin location unchanged but with alteration in the orientation of all line elements. Each stimulus was presented for 487 ms and instantly replaced by the following one. RESULTS: Segregation-related components for segregation-appearance (Sa) and for segregation-maintenance (Sm) conditions were obtained separately by subtraction. In both conditions, a negative component was obtained with a peak latency of about 140-150 ms. However, the onset of Sa was earlier than that of Sm, whereas the respective offsets were almost identical. CONCLUSIONS: We hypothesize that the segregation component in VEPs is composed of two subcomponents: an early part, which is related to the segregation of edges, and a final part, which is related to the 'filling-in' of the homogeneous texture surface within the boundary defined by these edges.

Adolescent↗

Assessment of pulmonary lesions with 18F-fluorodeoxyglucose positron imaging using coincidence mode gamma cameras.

UNLABELLED: Accurate assessment of lung carcinoma remains a significant clinical problem, often leading to surgical procedures without curative potential. PET with 18F-fluorodeoxyglucose (FDG) has shown promise in differentiating benign from malignant lesions and in staging the extent of disease, resulting in improved treatment at a significant cost savings. This multicenter prospective study used dual-detector coincidence imaging with FDG to categorize pulmonary lesions as benign or malignant. The goal of this study was to determine the sensitivity and specificity of dual-detector coincidence imaging of FDG in patients with pulmonary lesions who were scheduled to have a diagnostic procedure for histopathologic confirmation. METHODS: A total of 96 patients with pulmonary lesions with a lesion size ranging from 1 to 7 cm with a mean of 3.44 cm based on their chest radiograph or CT scan were studied using FDG scans with a dual-detector coincidence detection system. An additional 24 patients were entered as control subjects. The studies of 120 subjects were interpreted in random order by three physicians experienced in the use of FDG in patients with lung cancer. Surgical pathology was used as the standard for identifying malignant lesions. RESULTS: There was 94% agreement between the readers in the independent interpretation of the FDG studies. In the 96 patients with pulmonary lesions, FDG studies were 97% sensitive and 80% specific in identifying proven malignant lesions. CONCLUSION: The results of this prospective study provide evidence that dual-detector coincidence imaging with FDG provides an accurate, sensitive and specific means of diagnosing malignancy in patients with pulmonary lesions.

Case-Control Studies↗

Investigation on cerebral hemodynamics in patients with carotid disease receiving carotid endarterectomy.

100 patients (pts) receiving CEA (carotid endarterectomy) were evaluated in this study. In some of them postoperative complications were observed, characterized by TIA (transient ischemic attack) and, mostly, by cerebral hyperperfusion. In only two of the pts investigated CEA needed the implantation of a shunt, due to the emergence of intolerance signs at carotid Clamping (C) evaluated by TCD (transcranial Doppler); the preoperative cerebral angiography in the two subjects in question did not show malformations of the circle of Willis. The hyperperfusive phenomenon and the absence of intracranial compensation flows during CEA seemed to be ascribed to a more or less severe impairment of cerebral reserve. Such impairment of the autoregulatory capacity seems to be crucial to the pathogenesis of hemodynamic stroke. Thus the indication to CEA, in pts with severe carotid disease, should take into account also the cerebral reserve (CR) impairment to prevent both thromboembolic and hemodynamic stroke. The predictive and diagnostic role of TCD turns out to be crucial in assessing and selecting pts candidate to CEA.

Blood Pressure↗

[An analysis of the psychophysiological components in subjects with temporomandibular disorders. Myographic tension and the management of aggressiveness].

BACKGROUND: The stomatognathic literature doesn't sufficiently stress the role of aggressiveness as a modulator of muscular tensions. Our study focused on the hypothesis that 1) original psychological problems related to the modulation of aggressivity could produce 2) chronic muscular tension of the oral district 3) they can become the basis of the malocclusive phenomenon. The investigation was conducted in the laboratory of Clinical Psychophysiology of the University of Rome "La Sapienza". METHODS: We have examined the myographic activity of the temporal and masseter muscles of both sides in 20 women with temporomandibular dysfunction and in the control group comparable by age. The myographic tension was examined in three "stimulus situations": a) closed lips without any teeth contact; b) with light teeth contact; c) with compression of the dental arcade. Moreover, we have examined the style of aggressiveness modulation through Rosenzweig's PFS test. Features of the experimental group were. 1) age between 20 and 30 yrs; 2) presence of condylomeniscal uncoordination; 3) deviation of the median line of incisors; 4) lateral deviation in the opening and/or closing mandible. RESULTS: The experimental group showed a higher score of myographic amplitude for the above-mentioned muscles of both sides in three "stimulus situations". Moreover, it presented at the Rosenzweig's test more elevated scores for the Dominance of Obstacle (O-D); b) less elevated scores for Ego Defence (E-D). CONCLUSIONS: Results are commented on the basis of an integrated psychophysiological model.

Adult↗

Use of the Parental Bonding Instrument to compare interpretations of the parental bond by adolescent girls with restricting and binge/purging anorexia nervosa.

The Parental Bonding Instrument (PBI) was administered to 62 adolescent female patients (mean age 14.3): 35 with restricting-type anorexia nervosa (RAN), and 27 with binge/purging-type anorexia nervosa (B/PAN) according to the DSM-IV criteria, all at onset and initial diagnosis. The PBI was also administered to a control group (55 subjects) and 22 patients with Crohn's disease or celiac disease. The three groups were matched for age and socioeconomic status. The RAN and B/PAN patients gave significantly different interpretations of the parental bond (PB): for the former, it was adequate with both parents, for the latter it was inadequate, especially with the father. The fact that these differences exist at the onset of anorexia prior to any possible effect of therapy suggests that its structure is determined by different family dynamics.

Adolescent↗

Attentional selection by distractor suppression.

Selective attention was studied in displays containing singletons popping out for their odd form or color. The target was defined as the form-singleton, the distractor as the color-singleton. The task was to discriminate the length of a longer line inside the target. Target-distractor similarity was controlled using a threshold measurement as dependent variable in experiments in which distractor presence vs absence, bottom-up vs top-down selection (through knowledge of target features), and target-distractor distance were manipulated. The results in the bottom-up condition showed that length threshold was elevated when a distractor was present and that this elevation progressively increased as the number of distractors was increased from one to two. This set-size effect was not accounted by the hypothesis that selective attention intervenes only at the stage of decision before response. Selective attention produced a suppressive surround in which discriminability of neighboring objects was strongly reduced, and a larger surround in which discriminability was reduced by an approximately constant amount. Different results were found in the top-down condition in which target discriminability was unaffected by distractor presence and no effect of target-distractor distance was found. On the other hand, response times in both bottom-up and top-down conditions were slower the shorter the target-distractor distance was. On the basis of the experimental results, selective attention is a parallel process of spatial filtering at an intermediate processing level operating after objects have been segmented. This filtering stage explores high level interactions between objects taking control on combinatorial explosion by operating over only a limited spatial extent: it picks out a selected object and inhibits the neighboring objects; then, non-selected objects are suppressed across the overall image. When no feature-based selection is available in the current behavior, this filtering influences perception in decreasing discriminability of non-selected objects. When feature-based selection is available, spatial interactions are set before stimulus arrival, hence only the unmatching objects have their discriminability diminished.

Attention↗

Texture brightness filling-in.

The masking procedure by Paradiso and Nakayama (1991) (Vision Research, 31, 1221-1236) was used to investigate brightness filling-in within textures made of line elements: a texture stimulus was masked by a second stimulus containing a square contour. When a uniform texture was presented, the texture region inside the masking square appeared darkened and a small number of texture elements were perceived with a degenerated shape, appearing as dim dots or shorter line elements; it is as if the line element expanded from a bright point to fill the entire region defined by its contour. If the texture stimulus was a texture patch segregating from the surrounding texture by an orientation gradient and this patch was inside the square mask, darkening was not as strong as in the previous condition, and masked line elements preserved their elongated shape. Brightness spreading was measured in two experiments using dichoptic presentations. Experiment 1 used an adjustment task and showed that the brightness of texture line elements spread from equiluminant borders between segregating textures. Experiment 2 used a matching task and demonstrated that spreading was blocked by segregation borders dependent on the orientation gradient between texture line elements. The selectivity for line orientation began 40-80 msec after texture onset and maximal spreading occurred at approximately 120 msec. These findings may indicate that two processes subserve filling-in within textures: the first spreads isotropically the mean stimulus luminance at an initial processing stage of image analysis; at a later stage, the second spreads a texture flow (both brightness and shape of line elements) directed along the orientation of texture line elements. The texture flow mechanism fills in with a texture surface the region bounded by segregation contours.

Fixation, Ocular↗