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Biomedical subjects

G Caruso

Publications and source records attributed to G Caruso.

At least 145 records · Page 8Linked to original sources
PubMed1993

[Flowmetric analysis of thyroid diseases: hypothesis on integration with qualitative color-Doppler study].

After premising the value of qualitative color-Doppler analysis in the characterization of the main thyropathies through the identification of 4 main reference patterns, the authors investigate whether the quantitative information obtained by means of spectral analysis can improve the predictive value of color-Doppler US. One-hundred and seventy-six patients were examined and divided into 4 groups according to qualitative color-Doppler patterns, as reported in the literature. For each patient, flowmetry included the peak systolic frequency shift and the diastolic frequency shift. The Doppler shift was seen to differ greatly within each semiology class, with overlap of values between the various qualitative classes and between the different diseases. In conclusion, flowmetry provides no more useful diagnostic information than color-Doppler US in nodular or diffuse thyroid diseases.

Blood Flow Velocity↗
PubMed1993

[Echo-color Doppler in thyroid disease].

One-hundred and sixty-six patients affected with thyroid diseases were examined, together with 41 healthy volunteers, by means of color-Doppler US. Four main reference patterns were identified: no appreciable glandular flow (I); presence of signal in perinodular location (II); peri- and intranodular flow (III); increased vascularization (IV). In 72 cases, parenchymal and nodular goiters, with no signs of thyroid hyperfunction, were characterized as belonging to pattern III, while pattern II was observed in 57 nodular lesions; only in 7 patients was pattern III detected. Hyperfunctioning autonomous nodules exhibited pattern III in 10/11 cases and the same pattern was followed by the six carcinomas. Pattern IV resulted peculiar to Basedow disease and to glandular hyperplasia related to high values of circulating thyroid hormone (6 cases). When color-Doppler specificity in typifying the major thyreopathies can be confirmed, the possibility is actually in sight of reducing, in the near future, the number of thyroid scintigraphies and of US-guided needle biopsies.

Adolescent↗
PubMed1993

[The relation of moderate alcohol drinking and congestive heart insufficiency].

116 patients (53 women and 63 men) with congestive heart failure, secondary to chronic ischemic heart disease and/or hypertensive heart disease, were studied with the aim of assessing effects of moderate alcohol use on the clinical features of the disease. Two subgroups were considered: a) 57 moderate drinkers (11 women and 46 men); b) 59 non-drinkers or ex-drinkers (42 women, 17 men). Left ventricular mass/m2 (LVM/m2) is higher among moderate drinkers in comparison with non-drinkers (p < 0.001); this difference is present both in men (p < 0.05) and in women (p < 0.001). These results suggest that higher LVM/m2 of drinkers does not depend on sex and cigarette smoking; i.e., in males, a subgroup with the same prevalence of cigarette smokers among drinkers and non drinkers, congestive heart failure of drinkers is associated with a greater left ventricular enlargement. Our results suggest that moderate alcohol use can represent an additional pathogenetic factor for more severe clinical and laboratory features of congestive heart failure.

Aged↗
PubMed1992

Amiodarone-induced experimental acute neuropathy in rats.

Amiodarone was injected endoneurially at increasing doses into the exposed tibial nerve of rats to study its electrophysiologic and pathologic effects on peripheral nerve fibers. Forty-five male Wistar rats were used, and each of the following concentrations was injected into 15 nerves: 25 micrograms/mL, 50 micrograms/mL, and 100 micrograms/mL. Microinjection of a 25 micrograms/mL concentration of amiodarone resulted in a subacute, incomplete conduction block evident at day 3 postinjection. This conduction block remained stable until day 10 and recovery was complete at day 35. Microinjection of a 50 micrograms/mL concentration of amiodarone produced a faster evolving conduction block, and significant axon degeneration (approximately 40% of fibers). Injection of a 100 micrograms/mL concentration resulted in severe acute motor axon degeneration followed by complete but delayed regeneration. Results of morphological studies closely correlated with electrophysiological findings. Amiodarone thus seems to have a direct toxic effect on axons at high concentrations in the peripheral nerve, and we suggest that different pathological changes described in human amiodarone neuropathy could be related to different concentrations of the drug in the nerve, perhaps due to variability of blood-nerve barrier efficacy.

Amiodarone↗
PubMed1992

Italian neurologists and euthanasia: a poll.

We have tried to sound out Italian neurologists regarding their attitude to euthanasia, a very controversial issue today. We gave a short multiple-choice questionnaire to neurologists attending a national conference, asking their opinion on some issues related to euthanasia. 75 (25%) of the 300 doctors polled completed the questionnaire. Answers were often contradictory. A trend in favor of passive euthanasia among the respondents and a strong demand for guidelines are evident. Emotional rather than professional or rational factors seem to play a major role in the approach to this dilemma.

Attitude of Health Personnel↗
PubMed1992

Is early onset cerebellar ataxia with retained tendon reflexes identifiable by electrophysiologic and histologic profile? A comparison with Friedreich's ataxia.

An electrophysiologic and histologic study was performed on 18 patients affected by early onset cerebellar ataxia with retained tendon reflexes (EOCA). Sensory and motor conduction velocity (SCV, MCV) was measured along peripheral nerves in all patients, somatosensory (SSEP) and brainstem auditory evoked potentials (BAEP) were recorded in 13; cortical stimulation (CS) in 12, and sural nerve biopsy in 4 patients were also performed. The results as a whole allow a division of EOCA patients into 2 groups: with (7 patients) and without (11 patients) peripheral neuropathy. Among EOCA patients with neuropathy a differential diagnosis with Friedreich's disease patients was not possible according to BAEPs and CS, while SSEPs could differentiate 2 out 5 patients in whom they were performed.

Adolescent↗
PubMed1992

Determining the site of stimulation during magnetic stimulation of a peripheral nerve.

Magnetic stimulation has not been routinely used for studies of peripheral nerve conduction primarily because of uncertainty about the location of the stimulation site. We performed several experiments to locate the site of nerve stimulation. Uniform latency shifts, similar to those that can be obtained during electrical stimulation, were observed when a magnetic coil was moved along the median nerve in the region of the elbow, thereby ensuring that the properties of the nerve and surrounding volume conductor were uniform. By evoking muscle responses both electrically and magnetically and matching their latencies, amplitudes and shapes, the site of stimulation was determined to be 3.0 +/- 0.5 cm from the center of an 8-shaped coil toward the coil handle. When the polarity of the current was reversed by rotating the coil, the latency of the evoked response shifted by 0.65 +/- 0.05 msec, which implies that the site of stimulation was displaced 4.1 +/- 0.5 cm. Additional evidence of cathode- and anode-like behavior during magnetic stimulation comes from observations of preferential activation of motor responses over H-reflexes with stimulation of a distal site, and of preferential activation of H-reflexes over motor responses with stimulation of a proximal site. Analogous behavior is observed with electrical stimulation. These experiments were motivated by, and are qualitatively consistent with, a mathematical model of magnetic stimulation of an axon.

Adult↗
PubMed1992

POEMS syndrome: follow-up study of a case.

We report here the case of a 20-year-old man with POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M proteins, skin changes). This rare syndrome followed a 3-year history of a syndrome that mimics a chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with cyclophosphamide induced regression of the syndrome and improved peripheral nerve conduction.

Adult↗
PubMed1992

Occupational exposure to asbestos and urinary bladder cancer.

By the use of transmission electron microscopy (TEM) and energy dispersion spectrometry the amount (mean value mean = 191 +/- 94 fibers/mg of tissue) and the type (chrysotile and tremolite) of asbestos fibers have been determined in tissue samples of four bladder cancer patients affected by pulmonary asbestosis, working in the same plant producing asbestos-cement pipes and boards. Similar measurements were carried out on samples of bladder cancers of eight control patients not professionally exposed to asbestos. Only five of them also revealed chrysotile fibers (mean = 151 +/- 196 fibers/mg of tissue). The paucity of the study and control cases and the small quantitative difference between them regarding the presence of infraneoplastic asbestos fibers does not consent us to hypothesize a causal relationship between tumor and occupational exposure.

Aged↗
PubMed1992

The relationship between electrophysiological findings, upper limb growth and histological features of median and ulnar nerves in man.

In 19 median and 10 ulnar nerves of 28 healthy young volunteers, the maximum orthodromic sensory conduction velocity was studied along one or two fingers (the third and/or the fifth), the palm, and the forearm. In five 20 to 32-yr-old males and in a newborn male, post-mortem samples of either the median or the ulnar nerve were obtained from the finger (either the third or the fifth), the palm, the wrist and the forearm in order to study the size distribution of external fibre and axon diameters, and the fibre internodal length. In 2374 infants, children and adolescents, the height, length of both the third and the fifth finger, length of the palm, and length of the forearm were measured. The results showed (i) a significantly slower conduction velocity along the fingers; (ii) a significantly shorter internodal length without remarkable fibre diameter changes in the same nerve segments; (iii) a significantly smaller elongation of these body parts; (iv) a significant correlation between these data. In conclusion, internodal length seems to play an important role in governing conduction velocity of myelinated peripheral nerve fibres.

Adolescent↗
PubMed1992

Ventricular premature beats in young subjects without evidence of cardiac disease: histological findings.

This report describes the results of right ventricle endomyocardial biopsies from 26 subjects (mean age 27 +/- 10 years) with premature ventricular beats and normal cardiac anatomy and mechanical function. Light microscopy examination revealed normal myocardium in 10 subjects (38%), acute myocarditis in two (7%), borderline myocarditis in one (3.5%), non-specific histological abnormalities including cellular hypertrophy, fibrosis and degenerative changes in 11 (42%), vasculitis in one (3.5%) and findings compatible with right ventricular dysplasia in the final subject (3.5%). The frequency of ventricular premature beats, as assessed by Holter monitoring, and the results of electrophysiological testing did not correlate with histopathological findings and their severity. These data indicate that some young subjects with premature ventricular beats of unknown origin have abnormal right ventricular biopsy findings. Adequate follow-up will probably demonstrate the clinical utility of these observations.

Acute Disease↗
PubMed1992

Complement deficiency and antibody profile in survivors of meningococcal meningitis due to common serogroups in Italy.

A collaborative survey was carried out in Italy on a group of 59 subjects with a past history of meningococcal meningitis. The aim was to evaluate the prevalence of complement deficiencies, the serogroup of meningococci responsible for the disease and other possible immune abnormalities associated with the infection. Complement analysis allowed the detection of 10 cases (17%) with deficiencies of the terminal components, and in particular six cases of C8 beta, three of C7 and one of C6 defect. Half of the subjects with complement deficiencies had recurrences of meningitis and developed the infection at an older age in comparison with the control group with normal complement activity. The meningococcal C strain was the most diffuse (68%) and infected all the complement-deficient subjects. Evaluation of the antibody response to meningococcal capsular polysaccharides (PS) showed that only 42.5% of the individuals with group C had antibodies as opposed to 83% and 100% of the patients with meningitis due to group A and B, respectively. In all 59 subjects serum Ig as well as IgG subclasses were present, at normal levels for the age. Vaccination of seven out of the 24 subjects without detectable anti-meningococcal PS antibodies with the sole PS A+C induced a normal response in six of them, including a subject with complement defect. In the subject who did not respond to the antigen, the antibodies against the ubiquitous pneumococcal PS type 14 were also lacking, whereas anti-tetanus toxoid (TT) antibodies were normally present. From these data we may conclude the following: (1) the high prevalence (17%) of late complement components defect among survivors of meningococcal meningitis is also confirmed in the Italian population; (2) the serogroup C, responsible for the infections in all the cases with late complement components defect, is highly recirculating in Italy and apparently less immunogenic; (3) specific vaccination with meningococcal PS is a valid prophylaxis in subjects with lack of specific antibodies as well as in subjects with complement defect.

Adolescent↗
PubMed1992

Nerve conduction and electromyography.

The advent of computer-based methodology in routine electromyography has much improved the analysis of motor unit (MU) decomposition, of interference pattern study, and of MU counting. Measuring minimum motor and sensory conduction velocities is becoming more accessible and is considered an essential procedure in assessing the condition of peripheral nerves. A series of studies has shown that nerve resistance and vulnerability can be modified by a steep temperature gradient, by ciguatera toxin, or by hyperventilation-induced changes in the electrical properties of the axonal membrane. The controversy as to the diagnostic procedures to use in cases of radiculopathy and carpal tunnel syndrome (CTS) shows no sign of abating. There is, however, general consensus that electrophysiologic procedures must play a key diagnostic role in these conditions. Lastly, several interesting articles have been published describing the use of electrophysiologic tests in motor neurone diseases. Moreover, some advances have been made in the diagnostic yield of single-fibre electromyography (SFEMG) with axonal microstimulation in myasthenia gravis and Eaton-Lambert myasthenic syndrome.

Animals↗
PubMed1992

[Functional evaluation of the left ventricle in chronic pulmonary heart disease].

20 patients (18 m., 2 f., age 64.8 +/- 6.3 years), with chronic pulmonary heart disease (CPHD) secondary to chronic obstructive pulmonary disease and/or arterial hypertension were studied in comparison with a control group of subjects, age and sex matched, with normal respiratory function tests and without heart disease. CPHD patients did not show any difference of left ventricle (LV) systolic function, assessed by echocardiography, in comparison with the control group. However, among CPHD patients, significant correlations were found between lower arterial pH and cardiac output/m2 and between spirometric tests of bronchial obstruction and echocardiographic parameters of LV function. These results confirm that LV function in CPHD is maintained if other pathologic conditions are absent. On the other hand, correlations between echocardiography and spirometry and blood gas analysis strengthen the functional interdependence concept between left and right heart chambers.

Aged↗
PubMed1992

[Echotomography in the diagnosis of bone tumors. Work in progress].

Fifteen patients with positive conventional radiographs for morpho-structural neoplastic involvement of bone, were systematically submitted to US with a high-frequency probe (7.5 MHz). US evaluation was aimed at testing, relative to conventional radiography, the sensitivity of the former technique in recognizing the main elementary signs of bone involvement--e.g., cortical interruption, periosteal reaction, and extraosseous spread. In 13 cases where conventional radiography had shown cortical bone involvement, US always confirmed the radiographic findings, showing cortical interruption in all cases and allowing a preliminary evaluation of lesion size in 10 cases. Morphological and structural alterations of bone profile--i.e., interruption or evident thinning of the hyperechoic line corresponding to the cortical profile--were the main and preliminary signs of pathologic skeletal involvement. US is suggested as a complementary and integrative technique to conventional radiology, because it allows elementary signs of morpho-structural alterations of the cortical bone to be identified, and a preliminary evaluation of tumor size to be made.

Adolescent↗