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Biomedical subjects

G Madeddu

Publications and source records attributed to G Madeddu.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Diagnosis of hepatic hemangioma with simplified double 99mTc labelling].

The authors report on their experience with liver hemangioma (LH) diagnosis by means of a simplified method--that is, the simultaneous, in vivo, double labelling of liver reticuloendothelial system (RES) and of red blood cells (RBC) by 99mTc. Twenty-eight patients with US diagnosis of suspected LH and 15 controls were examined after sequential iv injection of SnCl2, of 99mTc-mucolloid albumin and, after liver scintigraphy, of 99mTc-pertechnetate to conclude in vivo RBC labelling. All patients underwent CT and, if necessary, CT-guided biopsy. Focal colloid defects filled after RBC labelling were shown in 20/22 patients with unquestionable LH. No colloid defects were shown in 6/28 cases (expansive process). 15/15 controls showed unchanged non-filling defects after double labelling. Finally, the authors point out that, in the diagnosis of LH, sequential double labelling of liver RES and RBC appears to be a quicker scintigraphic technique than conventional ones. Moreover, this technique has the same high specificity and sensitivity as more time-consuming ones.

Adult↗
PubMed1989

Beta-endorphin in experimental canine spinal ischemia.

Plasma and cerebrospinal fluid beta-endorphin concentrations were radioimmunologically assayed in dogs subjected to spinal cord ischemia induced by infrarenal aortic ligature and in control sham-operated dogs. Plasma beta-endorphin levels rose significantly following surgery in control dogs but were unaffected by spinal ischemia. On the other hand, a significant increase in cerebrospinal fluid beta-endorphin concentration occurred after spinal ischemia, while surgical stress had no significant effect. Thus, the origins of plasma and cerebrospinal fluid beta-endorphin may be different, with the former secreted from the hypophysis and the latter from nervous tissue. Observed changes in cerebrospinal fluid beta-endorphin concentration could be related to the ischemic lesion of nervous tissue while the changes in plasma levels may reflect general stressing factors such as the surgery in our experiments.

Animals↗
PubMed1985

Serum thyroglobulin levels in the diagnosis and follow-up of subacute 'painful' thyroiditis. A sequential study.

Serum thyroglobulin (Tg) levels were elevated in 92% of 38 patients with subacute "painful" thyroiditis in the early stage, independent of the extent of the disease and thyroid hormone concentrations. After two months of corticosteroid treatment, serum Tg levels were significantly decreased in 25 patients who could be rechecked, compared with the levels in the acute phase, although higher than those in our normal control subjects. Twelve of 25 patients underwent sequential measurements of Tg for three to four months, during the disease and after recovery. In ten the initially elevated values decreased rapidly to normal and were maintained for approximately 20 days. Then they rose gradually, peaked about 60 days after disease onset, then returned slowly and permanently to normal. In one patient who had a clinical relapse during the plateau phase, the Tg level also increased markedly and abruptly. Therefore, serial measurements of serum Tg can help in diagnosing and monitoring subacute "painful" thyroiditis.

Adolescent↗
PubMed1985

Diagnostic and prognostic value of TPA in breast cancer.

Serum tissue polypeptide antigen (TPA) was measured by RIA in 151 female patients who had had mastectomies for breast cancer, in 30 patients with benign breast disease, and in 30 normal controls. The marker was elevated in 52 neoplastic patients (25 with metastases) and in six cases of benign breast disease. At the time of our observation 15 cancer patients were at stage I, 53 at stage II, 48 at stage III, and 35 at stage IV, the prevalence of high TPA values significantly correlated with staging gradually increasing from 0 to 71.4% from stage I to IV. In patients with breast cancer TPA was significantly higher in the subgroup with metastatic disease compared to patients with apparently inactive disease. Nineteen patients without (group A) and 35 with metastases (group B) were monitored with serial measurements of TPA for 8-24 months. Group B was receiving either hormone or chemotherapy. In 10 group A patients TPA was either higher or rose 1-7 months prior to the clinical detection of metastases. Twenty-two patients from Group B had disease progression: In 20 of them TPA rose further. The remaining 13 patients had an apparent disease regression, and in 11 instances TPA either fell or remained normal. Thus TPA can detect early recurrence of breast cancer before clinical and instrumental methods; moreover, it might prove important in evaluating tumor response to treatment and in follow-up of patients with metastatic disease. Finally, serial measurements of TPA could identify previous false-positive results, thus improving the specificity of the test.

Adult↗
PubMed1984

Serum thyroglobulin in patients with autonomous thyroid nodules.

To investigate further the relationship between thyroid hormones and thyroglobulin (TG) secretion, total and free thyroid hormone levels, TSH and its response to TRH and serum TG concentrations were determined in 61 patients with solitary autonomous thyroid nodules. Thyroid function varied widely from euthyroidism to clearcut thyrotoxicosis. Serum TG levels were significantly higher in patients than in normal controls. Individually they were above the normal range (greater than 50 ng/ml) in 95% of the patients, as well as in those with normal total and/or free thyroid hormone levels. Patients with high total and/or free thyroid hormone levels had higher TG concentrations than euthyroid patients. TG concentrations were significantly correlated with FT3 values. They were higher in patients in whom TSH was unresponsive to TRH than in the responsive groups. TG was also slightly higher in patients with hot nodules than in those with warm nodules. These data seem to indicate that TG is secreted along with thyroid hormones in the absence of any stimulatory action. It also is a sensitive index of thyroid hyperfunction. Twenty patients were controlled 6 months after nodulectomy. TG levels, though significantly lower than in the preoperative state, were still higher than in normal subjects. This increase was attributed to persistent hyperthyroidism in two patients only. The observation that the increase in TSH after TRH stimulation in post-operative patients was greater than that found in normal controls led us to believe that in most cases the high TG levels after surgery are due to stimulation of the normal thyroid tissue by rebound TSH secretion.

Adolescent↗
PubMed1983

The TRH induced PRL release in patients with autonomous thyroid nodules before and after surgical treatment.

Total and free thyroid hormones (T3, T4, FT3, FT4), TSH and PRL were determined in basal conditions and after stimulation with TRH in 32 patients affected by autonomous thyroid nodules before and after nodulectomy and in 24 control subjects. Only 7 patients were clinically thyrotoxic and thyroid hormone concentrations were slightly elevated in most cases. In untreated patients the increment (delta) in PRL after TRH was significantly lower than in normal subjects but was not as severely depressed as that of TSH. After nodulectomy both delta PRL and delta TSH increased and were not significantly different from those found in normal subjects. Thus PRL responsiveness to TRH is depressed by prolonged though moderate increases in thyroid hormone concentrations but is not as sensitive to their action as TSH.

Adult↗
PubMed1983

Evaluation of peritoneovenous shunt patency with Tc-99m labeled microspheres.

The LeVeen peritoneovenous shunt (PVS) was investigated in 40 cirrhotic patients with refractory ascites. Five millicuries of Tc-99m-tagged human albumin microspheres (15-36 microns) were injected into the peritoneal cavity between the umbilicus and the left anterior superior iliac spine. The radiotracer was always detectable by scintigram in the lungs when the shunt was patent. In case of malfunction, by contrast, the radioactivity was either restricted to the venous tube or confined below the diaphragm for at least 4 hr. In the presence of complete obstruction, whereas the tube was not visualized after peritoneal injection, it was outlined by direct injection of 2 mCi of Tc-99m albumin microspheres into its subcutaneous tract, where it crossed the 12th rib, immediately above the valve. This technique sufficed to establish whether the site of obstruction was at the valve or in the tubing itself. In one patient, poor visualization of the tube and a delayed image of the lungs was caused by partial occlusion of the valve with fibrinoid debris. This radiotracer method proved simple, quick, and led to an immediate selective replacement when the shunt was not patent. Therefore, the use of this test is recommended for a definitive diagnosis, since there were neither false negatives nor false positives. No complications such as embolism or bacterial infection were encountered with Tc-99m human albumin microspheres, which are excellent tracers.

Adult↗
PubMed1981

Growth hormone (GH) secretion in hepatic encephalopathy.

Elevated plasma concentrations and abnormal secretory patterns of GH have been found in patients with cirrhosis of the liver. Displacement of brain dopaminergic monoamines by false "neurotransmitters' produced in the gut has been postulated as a cause of encephalopathy. In this study basal GH plasma levels and their response to TRH and L-DOPA were determined in thirty-nine cirrhotic patients and fifteen controls. Eleven patients had evidence of encephalopathy (Group 1), twenty-eight did not (Group 2). Both basal levels and the mean peak response to TRH were significantly higher in the cirrhotic patients that in the controls (Group 3). Peak values were moderately, but not significantly, higher in Group 1 than in Group 2. The response to L-DOPA was considerably lower in the encephalopathic patients in comparison with the subjects of both Group 2 and Group 3. This finding is consistent with depletion of active "neurotransmitters' in CNS. Our data fail to demonstrate clearly whether the paradoxical response to TRH can also be related to these abnormalities of monoamine metabolism in cirrhotics.

Adult↗
PubMed1981

[Study of the relations between recurrent nerve and inferior thyroid artery (author's transl)].

The importance of a knowledge of the relations between recurrent nerve and inferior thyroid artery, in order to minimise the incidence of injuries to the nerve during thyroidectomy, is stressed. These relations are analysed from the anatomo-surgical standpoint, with particular emphasis on the great variability to which they are subject. It is concluded by asserting the utility of prior location of the recurrent nerve, with an indication of some basic concepts that must always be borne in mind when performing thyroid surgery.

Arteries↗
PubMed1981

Role of 131Cs scan in preoperative diagnosis of nonfunctioning thyroid nodules.

The role of 131Cs scan in the preoperative diagnosis of cancer was evaluated in 355 patients with either cold or nonfunctioning thyroid nodules. Nodules were classified as positive, doubtful or negative by the pattern of isotope accumulation. Among 234 patients who underwent thyroidectomy, malignant lesions were found in 10.2 per cent of cases. All carcinomas but one found during surgery had been classified as positive by radiocesium scan and were considered as highly suspicious preoperatively; one carcinoma and two papillary adenomas had been classified doubtful and considered presumably malignant. False-positive nodules were found. However, we did not document histologically malignant lesions in nodules which were classified as negative by radiocesium uptake. The routine use of 131Cs scanning may be very useful in patients with cold or nonfunctioning thyroid nodules because of its high sensitivity in excluding malignant lesions.

Adenoma↗
PubMed1980

[The Peutz-Jeghers syndrome. Study of 2 familial cases].

Two new familial cases of Peutz-Jeghers syndrome are reported. The cases present a number of original aspects with regard to anomalous transmission of the defect, the common finding of a single ileal polyp and associated malformations in the first of the two cases. The clinical aspects of the disease are discussed together with the histology of the polyps in relation to their possibility or otherwise of degenerating. Finally, the various surgical techniques indicated for the treatment of this rare condition are examined.

Adolescent↗
PubMed1980

[The problem of cancer diagnosis in thyroid nodules: a study in an endemic area for goiter in North Sardinia].

In a 5-year prospective study in an endemic area for goiter, 275 patients with solitary thyroid nodules or with predominant nodules in multinodular goiters underwent surgery without selection on clinical grounds. The incidence of cancer was 13.1%. Preoperative diagnosis was based on personal history, local signs and radioisotope data. As compared with histologic findings, clinical and scanning data yielded a diagnostic accuracy of 19% and 31% respectively. 30% of all malignancies were not suspected preoperatively. 100% identification of cancer is possible only it all nodules are excised. Selection is, however, necessary: our data suggested that patients under 20 and over 50 years, all males, and goiters with more than 2 physical and/or scanning signs suspect for cancer should be operated upon. Much unnecessary surgery would be save and most, but not all, cancers would be excised.

Adolescent↗
PubMed1980

Role of serum carcinoembryonic antigen in preoperative diagnosis of cancer in patients with thyroid nodules.

Serum carcinoembryonic antigen (CEA) was measured by double antibody radioimmunoassay technique in 95 normal subjects and in 258 patients with thyroid nodules. All the normal subjects and the patients with benign nodules had normal CEA values. Increased serum CEA levels (above 50 ng/ml) were found in all medullary and undifferentiated (giant cell) carcinomas. After surgery, the CEA fell within the normal range in the patients with medullary carcinoma. High levels of CEA were also present in 26% of differentiated carcinomas. A relationship between high CEA values and the presence of metastatic disease was not found. Measurement of serum carciniembryonic antigen may be useful in the preoperative diagnosis of cancer in patients with thyroid nodules.

Carcinoembryonic Antigen↗
PubMed1980

Alteration of thyroid function in the early stage of subacute thyroiditis.

Measurement of serum triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), thyroxine-binding-globulin (TGB), antithyroglobulin antibodies (anti-hTg), thyroid 131I uptake and scanning was performed on 12 patients during the early phase of subacute thyroiditis. Serum thyrotropin (TSH) was measured during baseline conditions and following administration of synthetic thyrotropin-releasing-hormone (TRH). The stimulation with exogenous TSH was performed on 7 subjects. 131I uptake was depressed in all patients including those with solitary nodules. Free and total hormone concentrations were elevated in the three cases with diffuse gland involvement, whereas an increase of T3 alone was present in 3 patients with unilobar involvement. In the latter group and in the 2 patients with a nodular form T4, FT3 and FT4 levels were within normal limits. Interruption of the pituitary-thyroid feed-back mechanism with absence of thyrotropin response to TRH occurred in 11 patients, independent of whether thyroid hormone concentrations were elevated or normal. In one patient only with unilateral involvement, TSH responsiveness to TRH was normal while 131I uptake was not raised by exogenous TSH, indicating diffuse cellular damage. The normal values of FT3 and FT4 found in patients with normal T3 and T4 levels seem to exclude the possibility that the free hormones are responsible for the interrupted feed-back which represents the main cause of suppressed iodine uptake. However, it is possible that the pituitary-thyroid axis is responding to transient or light increases of free and total T3 and T4 still within their 'normal range'.

Adult↗