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Biomedical subjects

G Perri

Publications and source records attributed to G Perri.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Adrenal myelolipomas: their magnetic resonance assessment].

Adrenal myelolipomas are rare nonfunctioning neoplasias consisting of a variable mixture of mature fat and bone marrow tissue. In the present study MRI appearances of six adrenal myelolipomas are presented. MR exams of six patients in which a conclusive diagnosis of adrenal myelolipomas was reached by means of surgery (1 case), US-guided fine-needle biopsy (3 cases) and typical diagnostic imaging in association with stability on US follow-up for at least two years (2 cases) were retrospectively evaluated. MR sequences protocol included pre- and post-contrast (Gd-DTPA) SE T1-weighted images and SE proton density and T2-weighted images. Five adrenal masses were examined by means of combination of gadolinium administration with a SE T1-weighted modified three-point Dixon technique. Three different MR structural patterns were pointed out: a) homogeneous hyperintense masses on T1-weighted images with intermediate signal on T2-weighted images, suggestive for predominantly fat-containing lesions (2 cases); b) heterogeneous masses with fat intensity areas and hyperintense areas on T2-weighted images and on post-contrast T1-weighted images, suitable for mixed fatty and myeloid elements (2 cases); c) nodules hypointense to the liver on T1-weighted images and hyperintense on T2-weighted images and after gadolinium administration, suggesting tumors primarily composed of myeloid cells (2 cases). A precise determination of fatty and myeloid elements within the lesions was observed by means of "water" and "fat" images provided by modified three-point Dixon technique. In conclusion, MRI allows to determine the various structural components of myelolipomas and therefore appears to be a very reliable technique in the diagnosis and characterization of the different structural patterns of this rare adrenal pathology.

Adrenal Gland Neoplasms↗
PubMed1995

Short-term effect of testosterone treatment on reduced bone density in boys with constitutional delay of puberty.

We studied bone mineral content (BMC), bone mineral density (BMD), cortical thickness/total width (CT/TW) ratio and cortical area/total area (CA/TA) ratio in boys with constitutional delay of puberty and the effect of short-term testosterone treatment on bone mass. Seventeen boys (age 13.1-15.8 years) who met the family history and the clinical criteria of constitutional delay of puberty were selected and enrolled in the study. All subjects were eating a diet assuring an adequate intake of calories and calcium. A subset of 8 boys (group A) was treated with testosterone depot (100 mg/month x 6 months) while 9 boys (group B) were not. At inclusion, BMC and BMD were reduced in the patients according to their chronological age (BMC -4.04 +/- 1.34 standard deviation scores [SDS]; BMD -2.95 +/- 0.56 SDS), statural age (BMC -1.75 +/- 0.79 SDS; BMD -1.69 +/- 0.78 SDS), and bone age (BMC -1.80 +/- 0.65 SDS; BMD -1.86 +/- 0.68 SDS). No significant differences between the groups were found (group A: BMC 0.480 +/- 0.57 g/cm, BMD 0.488 +/- 0.037 g/cm2, CT/TW ratio 0.43 +/- 0.4, CA/TA ratio 0.68 +/- 0.04; group B: BMC 0.476 +/- 0.060, p = NS vs. group A; BMD 0.491 +/- 0.036 g/cm2, p = NS vs. group A). At 12 months of follow-up, BMC, BMD, CT/TW ratio, and CA/TA ratio significantly increased in group A (BMC 0.70 +/- 0.13 g/cm, delta +41.1 +/- 28.8%, p < 0.003 vs. 0 month; BMD 0.617 +/- 0.082 g/cm2, delta +26.2 +/- 13.6%, p < 0.005 vs. 0 month; CT/TW ratio 0.52 +/- 0.05, delta +20.59 +/- 10.65%, p < 0.001 vs. 0 month; CA/TA ratio 0.77 +/- 0.05 vs. 0 month; CT/TW ratio 13.60 +/- 6.65%, p < 0.004 vs 0 month), but not in group B (BMC: 0.48 +/- 0.05 g/cm; delta +5.1 7.8%, p = NS vs. 00 month; BMD: 0.492 +/- 0.037 g/cm2; delta +0.54 +/- 8.7%, p = NS vs. 0 month; CT/TW ratio 0.44 +/- 0.04, delta +4.04 +/- 6.75%, p = NS vs. 0 month; CA/TA ratio 0.68 +/- 0.05, delta +2.39 +/- 5.90%, p = NS vs. 0 month). We conclude that boys with constitutional delay of puberty have reduced BMC and BMD. The delay in statural and bone ages did not totally account for the decreased bone mass. Testosterone treatment for 6 months significantly increased BMC, BMD, CT/TW ratio, and CA/TA ratio in these patients, but definitive conclusions on the efficacy of the treatment in improving adult bone mass can be drawn only when our patients reach early childhood.

Adolescent↗
PubMed1995

Association between X-linked hypophosphatemic rickets and Klinefelter's syndrome: effects on growth and body proportion.

Growth failure with disproportionate short stature is the major clinical feature of patients with X-linked hypophosphatemic rickets (HYP). We studied the pattern of linear growth and body proportion in an untreated normally growing HYP child also affected by Klinefelter's syndrome. Auxologic data were compared with those of a HYP half-brother who showed growth failure despite long-term treatment either with vitamin D or with vitamin-D-analog plus phosphate salt supplementation. The degree of body disproportion changed from negative values to positive values in the proband, whereas it was reduced in the half-brother. We conclude that, in the proband, the normal pattern of growth and the lack of the typical body disproportion as seen in HYP patients are attributable to the concomitant presence of Klinefelter's syndrome.

Adolescent↗
PubMed1995

Long-term growth hormone treatment in children with renal hypophosphatemic rickets: effects on growth, mineral metabolism, and bone density.

OBJECTIVE: To evaluate the effects of treatment with recombinant human growth hormone (rhGH) on growth, mineral metabolism, and bone density in children with renal hypophosphatemic rickets (RHR). DESIGN: Long-term rhGH treatment combined with conventional therapy with 1,25-dihydroxyvitamin D3 plus inorganic phosphate salts. SETTING: Endocrine unit, department of pediatrics, university hospital. SUBJECTS: Twelve patients (5 boys; age range 4.6 to 12.5 years, median 7.0 years) were subdivided into two groups of six patients on the basis of the median of height z score (-2.41) and the median bone age/statural age (BA/SA) ratio (1.23). Group A included patients with a severe degree of short stature (height z score -3.4 +/- 0.5) (mean +/- SD) and altered BA/SA ratio (1.26 +/- 0.08); group B included patients with a lesser degree of short stature (height z score -2.1 +/- 0.6, p < 0.001 vs group A) and more normal BA/SA ratio (1.04 +/- 0.15, p < 0.01 vs group A). INTERVENTION: Group A received rhGH treatment (0.6 IU/kg per week subcutaneously) combined with conventional therapy; group B received conventional therapy alone. MEASUREMENTS: Height, growth velocity, predicted adult height, serum values of calcium, phosphate, bone alkaline phosphatase isoenzyme, osteocalcin, propeptides of type I and type III procollagen, intact parathyroid hormone, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and urinary calcium/urinary creatinine ratio and tubular maximum for phosphate reabsorption normalized to the glomerular filtration rate (TmP/GFR), as well as radial bone density, were measured at baseline and for 3 years. RESULTS: Height z score, growth velocity z score, predicted adult height, serum values of phosphate, bone alkaline phosphatase isoenzyme, osteocalcin, propeptides of type I and type III procollagen, intact parathyroid hormone 1,25-dihydroxyvitamin D, and TmP/GFR, as well as radial bone density, improved significantly only in group A. Serum calcium and 25-hydroxyvitamin D, and urinary calcium/urinary creatinine ratio did not change in either group. CONCLUSIONS: Long-term rhGH administration may benefit growth, phosphate retention, and bone density in patients with RHR, without evidence of side effects.

Bone Density↗
PubMed1995

Segmental organization of the pig liver: anatomical basis of controlled partition for experimental grafting.

Segmental anatomy has been investigated on 54 pig livers by bench-top radiology and ultrasonography of hepatic and portal vessels and bile ducts and dissection of suprahepatic veins. Eight segments were recognized, homologous to those of the human liver. Major variations were found only of arterial distribution. The inferior vena cava invariably ran within the parenchyma of the right lobe and close to the liver hilum; suprahepatic veins were also entirely intraparenchymal. Therefore, the pig liver can easily be divided into two halves, but only the right one can be used for reduced-size grafting into a recipient.

Animals↗
PubMed1994

Growth hormone secretion in poorly growing children with renal hypophosphataemic rickets.

We evaluated growth hormone (GH) secretion and baseline serum free insulin-like growth factor-I (IGF-I) levels in 12 poorly growing patients (5 males and 7 females; age 1.6-12.5 years, median 6.4) with renal hypophosphataemic rickets treated with 1,25-dihydroxy-vitamin D3 plus inorganic oral phosphate salts. Eleven healthy normally growing children (6 males and 5 females; age 3.1-10.8 years, median 6.6) were studied as control group. All patients had a normal GH response (GH peak > or = 10 micrograms/l) to at least one provocative pharmacological stimulus (levodopa or insulin tolerance test), as well as all the controls. Mean growth hormone concentrations (MGHC), mean pulse amplitude, number of GH peaks above 5 micrograms/l, and IGF-I values overlapped between patients and controls, even though four patients had MGHC below the lower limit of MGHC of controls. In these patients, however, height-SDS, serum calcium, phosphate, alkaline phosphatase, intact parathyroid hormone, 1,25-dihydroxyvitamin D concentrations and maximum tubular phosphate reabsorption/glomerular filtration rate ratio did not differ in respect to the patients who showed MGHC in the range of controls (n = 6). MGHC IGF-I and biochemical parameters of phospho-calcium metabolism did not differ when the patients were subdivided in two groups on the basis of the median (-2.4) of height-SDS. No relationship was found between MGHC or IGF-I and height-SDS or growth velocity-SDS. Height-SDS and years of treatment or age at which therapy was started were not related.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1994

[Role of color-Doppler in the assessment of erectile impotence: personal experience].

We present our experience with colour duplex sonography in the assessment of 38 impotent men, whose ten underwent radical prostatectomy, following intracavernous pharmacological stimulation with PGE1. All patients with a clinical good response following PGE1 injection had peak cavernosal artery velocities > 30 cm/sec. The remaining suboptimal responders who presented an elevated end-diastolic velocity (> 5 cm/sec) showed a venous leakage demonstrated with cavernosography. Colour duplex sonography is a valuable and non-invasive tool in the assessment of impotence and can provide valuable information in the diagnosis of vasculogenic erectile dysfunction.

Aged↗
PubMed1993

Haematocervix during hormonal replacement therapy.

A postmenopausal woman, receiving cyclic hormonal therapy, presented to our clinic with acute pelvic pain, absence of withdrawal bleeding and clinical signs of vagal stimulation (nausea and vomiting). Vaginal exploration and ultrasonographic imaging accounted for haematocervix, which was confirmed by surgical blood evacuation.

Estrogen Replacement Therapy↗
PubMed1992

[Pulmonary tuberculosis and other mycobacterial infections in patients with AIDS].

Nowadays, the acquired immune deficiency syndrome (AIDS) is most certainly the major cause of the increased incidence of tuberculosis (TBC). A total of 138 patients (pts) with AIDS were referred to the Department of Infectious Diseases of the Hospital of Pisa, 1990-1991; 14 of them (10.1%) presented pulmonary TBC. In our study, we analyzed the chest films of the latter group of patients. Based on the X-ray patterns, the findings were classified as follows: hilar lymph nodes were observed in 4 pts (28.6%), isolated lymph nodes in 2 cases; associated with parenchymal involvement in 2 pts; acute alveolar TBC was seen in 4 cases (28.6%), with escavations in 3/4 (21.4%). Linear and reticular TBC were found in 4 pts (28.6%), and miliary interstitial involvement in 1 case (7%), extrapulmonary adenopathy in 4 pts (28.6%). In 4 pts (28.6%) chest X-ray findings were negative. All pts underwent serial chest X-rays in the course of therapy. HRCT was performed in 6 patients: our results are in agreement with those reported in literature. Thus, we can conclude that the major diagnostic findings in our series were: frequent isolated involvement of hilar lymph nodes, as observed in primary TBC; the infiltrates are most frequently located in the middle and basal lobes; escavations are uncommon; pleural effusion is unusual; in some pts chest X-ray findings may be negative.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Digital subtraction radiography in pediatric cystourethrography.

Digital subtraction radiography (DSR) was used to evaluate the anatomy and function of the bladder and urethra in 20 children with clinical urinary disturbances deriving from recurrent urinary tract infections. Following image subtraction, a complete study of bladder and urethra morphology and activity before and during voiding was obtained. Furthermore, DSR permitted a reduction in exposure doses given to children compared to conventional film-screen examinations. Results indicate the applicability of this technique for use on a wider scale and suggest its use as an alternative to other diagnostical techniques for the study of this subject.

Child, Preschool↗
PubMed1991

Mineral metabolism and calcitriol therapy in idiopathic juvenile osteoporosis.

Idiopathic juvenile osteoporosis is a rare cause of osteoporosis during childhood. We examined four children (three boys and one girl, ranging in age from 2.3 to 12.6 years) with idiopathic juvenile osteoporosis. All of these patients had normal serum calcium, ionized calcium, phosphate, magnesium, 25-hydroxyvitamin D, intact parathyroid hormone, and total and extractable calcitonin levels. 1,25-Dihydroxyvitamin D values were low in three patients and slightly decreased in one. Three children were treated with calcitriol (1,25-dihydroxycholecalciferol) (0.50 micrograms/d in two and 0.25 microgram/d in the other). The fourth patient was not treated because of parental refusal. Therapy reduced the fracture rate. Follow-up at 6 and 12 months showed a significant increase in bone mineralization, which reached normal values in two children after 12 months of treatment. No side effects of calcitriol therapy were observed. The untreated patient did not show an improvement of bone mineralization in the same time.

Bone Density↗
PubMed1991

[The echographic picture of the breast following quadrantectomy and radiation therapy].

Our experience moved from the clinical relevance of an eventual positive role of US in the follow-up of breast cancers treated with conservative therapy. This trial was suggested by the more and more frequent use of conservative therapy an by the diagnostic difficulties offered by the breasts treated with surgery and radiation therapy. Aim of the study is to analyze the diagnostic value of US in the identification of local relapse in a group of 60 patients with breast carcinoma (stages I and II) treated with conservative therapy. The patients were studied for at least 2 years following treatment, with clinical, US, and mammographic controls at 6, 12, and 24 months. The following clinical problems were considered: 1) study of the US patterns of the morphological and structural changes induced by conservative treatment; 2) observation of US and mammographic agreement in case of local relapse; 3) role of US in the follow-up of this kind of patients. US patterns and results at 6 months follow: cutaneous scar (60/60 cases), skin thickening (55/60), architectural distortion (asymmetry and amputation of the glandular cone, intramammary scar) (52/60), volumetric changes in the treated breast (50/60), skin asymmetry and retraction (50/60), "parenchymal fibrosis" (48/60), mass (8/60) and calcifications (3/60). As for the very few relapses (4 cases), US failed to reveal a ductal carcinoma which presented as microcalcifications. In our experience, US is a complementary exam to clinical and radiologic investigations, especially in the period immediately following therapy and in case of particular clinical problems, such as increased breast volume, mastitis, and appearance of a nodule.

Adult↗
PubMed1991

[Double-contrast enema. Study of the mucosal pattern and the organ profile with conventional and digital methods].

A solid state digital system (FCR 101) was employed in our comparative evaluation of the image quality of conventional versus digital techniques in the study of colon by means of double-contrast enema. Sixty patients were examined with a single AP view, using digital radiography with 100% radiation dose and progressive 50% and 75% reductions; the radiographs thus obtained were then compared with the corresponding conventional ones. The examined parameters were organ profile and mucosal pattern. Each digital and conventional radiograph was evaluated by 2 independent radiologists and a value was given to each parameter i.e., 1 = good, 2 = sufficient, 3 = insufficient. Upon comparison of the average values obtained for digital and conventional radiographs in optimal conditions and with a dose reduced by 50%, the digital technique was seen to give a more detailed and accurate representation of both low-contrast mucosal pattern and of organ profile. With the dose reduced by 75%, a slight increase was observed in background noise which caused a slight loss in image definition, but this did not reduce image readability with respect to conventional radiographs. To conclude, the digital method with a 50% exposure reduction is to be preferred in the examination of the colon, especially in pediatric radiology; furthermore, since this technique allows better detailing at lower contrast, it is to be preferred in the study of the pathologic conditions affecting mainly/only the mucosal pattern--e.g., cancer, ulcerative colitis, Crohn's disease, and so on. An exposure dose reduced by 75% may be used for following lesions previously diagnosed and when a less detailed depiction of the mucosal pattern is enough.

Adult↗
PubMed1990

[Impact of high resolution computerized tomography on the clinical assessment of pulmonary interstitial diseases].

Our purpose is to define the morphological patterns of interstitial lung disease on CT and to evaluate the diagnostic impact of high-resolution technique (HRCT). Sixty-six consecutive patients with proven interstitial lung disease were considered in our study. The basic morphological patterns include: a) large reticular pattern (10-25 mm); b) small reticular pattern (2-3 mm); c) intermediate reticular pattern (5-10 mm) with cystic dilatation of distal airspaces; d) nodular pattern; e) high-density parenchymal areas. Topography of the involved areas (peripheral, middle and axial compartments), and lesion distribution with reference to the secondary pulmonary lobule (centrilobular, perilobular, panlobular, bronchovasal) are additional diagnostic criteria. The identification and correlation of these three parameters proved very useful in limiting the range of diagnostic possibilities to interstitial disease, obviously considering clinical data. In our series a correct CT diagnosis was obtained in 57 of 66 cases (86.36%). In 24 of them (36.34%) diagnosis corrected a previous erroneous or generic clinical suspicion. Our data suggest that HRCT is indicated in interstitial lund disease when neither clinical nor radiographic findings allow a specific diagnosis to be made.

Diagnostic Errors↗