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Biomedical subjects

L Celentano

Publications and source records attributed to L Celentano.

At least 37 records · Page 2Linked to original sources
PubMed1992

Per-rectal portal scintigraphy with technetium-99m pertechnetate for the early diagnosis of cirrhosis in patients with chronic hepatitis.

We evaluated the role of per-rectal portal scintigraphy with 99m-technetium pertechnetate (99m-Tc test) for early diagnosis of cirrhosis. Forty patients with biochemical evidence of chronic liver disease were studied. Laparobiopsy documented chronic active hepatitis (CAH) without cirrhosis in 22 of the patients and CAH with cirrhosis (CAHc) in 18 patients. Clinical or laboratory findings could not differentiate between CAH and CAHc. Twelve healthy volunteers served as controls. The results, expressed as shunt index (SI), i.e., the ratio between heart radioactivity and the sum of heart and liver radioactivity in the first 30 s of observation, were: controls 5.66 +/- 1.66, CAH 15.27 +/- 2.83 and CAHc 24.88 +/- 3.95. A significant difference between the mean SI values in the three groups studied (F = 142.71, p less than 0.0001) was observed. At values less than 17, our test showed a predictivity of 100% for cirrhosis exclusion, while at values higher than 19 the predictive positive value for a diagnosis of cirrhosis was 100%. Invasive diagnostic procedures should be performed only in patients with SI values between 17-19.

Adult↗
PubMed1992

Diagnosis of coronary artery disease with Tc 99m-methoxy isobutyl isonitrile and transesophageal pacing.

Recently the use of a new radioactive agent with physical and biological properties more favorable than those of thallium 201, methoxy-isobutyl-isonitrile (MIBI) labeled with technetium 99m (Tc 99m), has permitted simultaneous performance of perfusion and function studies in ischemic cardiopathy. Transesophageal atrial pacing (TAP) technique has evolved as an alternative provocative test of ischemia. The authors compared the capability of Tc 99m-MIBI myocardial scintigraphy, combined with TAP, with that of Tc 99m-MIBI, combined with maximal stress test, in the diagnosis of ischemic cardiopathy. They studied 11 patients with a clinical history of angina pectoris. Myocardial scintigraphy was performed at rest, after stress test, and after TAP. Finally, all the patients underwent coronary angiography. The analysis of myocardial perfusion images on both Tc 99m-MIBI associated with TAP and with stress demonstrated, in 165 myocardial segments examined: 143 normal, 20 reversible defects, 2 irreversible defects. The concordance of localization between coronarographic data and scintigraphic reversible and irreversible defects was 85%. In conclusion TAP proves to be a valid and sensitive provocative test of ischemia when combined with myocardial scintigraphy and with Tc 99m-MIBI.

Cardiac Pacing, Artificial↗
PubMed1992

Radioisotopic cisternography in benign intracranial hypertension of young obese women. A seven-case study and pathogenetic suggestions.

The Authors report a series of seven obese women suffering from Benign Intracranial Hypertension (BIH), all submitted to radioisotopic cisternography. Cisternographic findings showed altered patterns of CSF clearance in all but one patient, suggesting that an increased arachnoid resistance to CSF efflux might be present in BIH of obese women. The pathophysiology of BIH is discussed: different pathogenetic mechanisms may contribute to its development with a relative importance depending on the specific etiology of the syndrome.

Adult↗
PubMed1991

Effects of atrial natriuretic peptide on glomerular filtration rate in essential hypertension: a radionuclide study.

A number of studies show that atrial natriuretic peptide (ANP) raises renal sodium excretion with a concomitant increase in glomerular filtration rate (GFR) in both experimental animals and normal humans. Studies using indirect evaluation of GFR have provided less consistent results in hypertensive patients. We studied the effects of intravenously administered (iv) alpha-human ANP on GFR in patients with hypertension by a radionuclide technique using technetium 99m diethylenetriaminepenta-acetic acid. In six patients (ANP group), GFR was determined under control conditions, during iv ANP (initial bolus of 0.5 micrograms/kg followed by a 21-min maintenance infusion at 0.05 micrograms.kg-1.min-1) and during a recovery phase. In six other patients (control group), GFR was determined under control conditions, during saline iv infusion and during recovery. The two groups did not differ with respect to age, sex, basal blood pressure, heart rate or GFR. In the ANP group, the infusion of the peptide induced a significant decrease of mean blood pressure (from 133 +/- 5 to 120 +/- 5 mmHg, P less than 0.01), no change in heart rate and a significant increase in GFR (from 104 +/- 4 to 125 +/- 5 ml/min, P less than 0.01). During recovery, blood pressure, heart rate and GFR were not different from the values recorded under control conditions. No changes in blood pressure, heart rate or GFR (from 106 +/- 5 to 108 +/- 5 ml/min, n.s.) were detected during saline infusion in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Morpho-functional evaluation of hypertensive patients with renal artery stenosis. Correlations between angiography and dynamic scintigraphy].

Renovascular hypertension is the most important and common cause of secondary hypertension. We studied 10 patients with arterial hypertension and different degrees of renal artery stenosis to assess the usefulness of dynamic radionuclide renography in evaluating renal perfusion and function, and to compare functional radionuclide results to the morphological findings of renal angiography. Computer-assisted dynamic renal imaging with 99mTc diethylenetriaminepentaacetic acid (DTPA) and 131I ortho-iodohippurate (OIH), and renal arteriography were also employed in all patients. In all patients, radionuclide results matched angiographic findings in quality. In particular, 3 patients with hemodynamically insignificant renal artery stenosis exhibited normal perfusion and function at dynamic radionuclide renography. Seven patients had significant renal artery stenosis and associated functional changes at dynamic radionuclide renography. Quantitative comparison of all patients showed a significant correlation (r = 0.866, p less than 0.001) between the degree of renal artery stenosis, quantified as the percentage of narrowing as compared to adjacent/contralateral normal vessel diameter, and the results of split renal function, as assessed during OIH studies and expressed per kidney as a percentage of the net total counts of both kidneys. In conclusion, our results demonstrated dynamic radionuclide renography to be a valuable tool in the assessment of functional changes secondary to renal artery stenosis in hypertensive patients, providing complementary results to arteriography.

Adolescent↗
PubMed1989

Renal artery stenosis detection by combined Gates' technique and captopril test in hypertensive patients.

We studied 11 hypertensive patients by a radionuclide technique using Gates' method with [99mTc]DTPA to investigate the acute effects of captopril on glomerular filtration rate (GFR). Five patients had hypertension with unilateral renal artery stenosis (RAS) angiographically documented and six patients had essential hypertension (EH). Total and split GFR were determined under control conditions and after oral administration of captopril (50 mg). In the patients with RAS, captopril induced a significant decrease of GFR in the stenotic kidneys (from 42.4 +/- 4 to 29.6 +/- 3 ml/min, p less than 0.01), while no changes were observed in the nonstenotic kidneys (from 61.2 +/- 3 to 61.6 +/- 5 ml/min, NS). Total GFR was 103.6 +/- 5 ml/min under control conditions and decreased to 91.8 +/- 6 ml/min after captopril (p less than 0.05). No significant changes of GFR were detected after captopril administration in patients with EH. In a separate group of ten patients with EH, good correlation between 24-hr creatinine clearance and fractional uptake of [99mTc]DTPA was obtained. Good reproducibility of this radionuclide technique was also shown. This study demonstrates that the computed radionuclide GFR determination coupled with the captopril test allows one to unmask angiotensin II-dependent renal function and hemodynamic changes. This technique can be useful in clinical practice for identifying patients with renovascular hypertension.

Adult↗
PubMed1987

Non-Hodgkin's lymphoma in childhood presenting as thyroid enlargement.

The authors report a case of a 10-year-old girl with early involvement of the thyroid gland by non-Hodgkin's lymphoma, an uncommon site of presentation of childhood lymphomas. In pediatrics, thyroid enlargement is more often caused by lymphocytic thyroiditis. The good response to therapy, in spite of the advanced stage of the disease, is noted.

Child↗
PubMed1986

Pre-operative axillary lymphoscintigraphy in breast cancer: experience with sub-areolar injection of 99Tcm-nanocolloidal albumin.

Thirty-two patients affected by monolateral breast cancer and five patients with benign mammary pathology were submitted to pre-operative lymphoscintigraphy by sub-areolar injection of nanocolloidal albumin with the aim of evaluating any axillary lymphonodular involvement. The 32 patients, affected by cancer, subsequently underwent a surgical operation so as to permit a pathological-anatomical study of the axillary cavity. A comparison between the clinical and instrumental examinations brought to light the much greater reliability of the latter which gave 87.5% of correct diagnoses. The authors emphasize the absence of false positive results and the excellent sensitivity of the method in bringing to light even limited involvements of the axillary lymphonodes. The authors believe that axillary lymphoscintigraphy deserves to be included in the pre-operative protocols which afford a correct staging of the disease and, consequently, a better assessment of the extent of the surgical action.

Adult↗
PubMed1976

[In vitro thyroid diagnosis in surgery of the thyroid].

After a brief outline of the physiology of the thyroid hormones and the laboratory tests measuring thyroid function, the dosage of normalised T4 (T4N) in patients suffering from various thyroid diseases and subjected to surgical operation is discussed. As the fundamental presupposition of thyroid surgery is that the operation is made in conditions of euthyroidism, the use of a quick and reliable preoperative test giving an exact evaluation of the patient's thyrometabolic conditions is necessary. In conclusion it is stated, on the basis of experience acquired in 90 patients operated for various thyriod diseases, that the last thyrometabolic evaluation can be based on T4N dosage.

Adolescent↗
PubMed1975

[Radioimmunoquantization of the HBAg in clinical liver diseases].

The two-step direct radioimmune test RIA used to detect hepatitis B virus associated antigen (HBsAg) appeared to be more sensitive than other immunologic assays. RIA demonstrated as HBsAg positive 90% of 20 patients with posttransfusion hepatitis; 88% of 50 patients with acute viral hepatitis; 100% of 13 patients with chronic active hepatitis and 35% of 20 patients with cirrhosis; on the other hand with positivity for HBsAg in the same patients appeared to be lower by AGD, CIEP and CF. The quantitation of HBsAg by RIA has been performed with a dose response curve obtained by use of HBsAg (ad) standard. The quantitative HBsAg data of an eight week follow-up of fully recovered 15 patients with acute B-hepatitis are reported. In the first week it appeared a distribution of the HBsAg levels into three classes of values. The concentration of HBsAg in the serum became lower week by week and in the 8th week the HBsAg was no longer detectable. The radioimmunoquantitation of HBsAg in the serum of patients suffering from chronic active hepatitis and cirrhosis showed levels of antigenaemia ranging between 17 and 5100 ng ad equivalent/ml. The use of a dose response standard curve in order to quantify HBsAg in the serum represents a further increased sensitivity of RIA.

Acute Disease↗
PubMedDate not supplied

Thallium-201 per rectum for the diagnosis of cirrhosis in patients with asymptomatic chronic hepatitis.

In normal subjects, thallium-201, administered per rectum, is taken up mainly by the liver (heart/liver ratio in normal subjects: 0.04 to 0.12). It has been claimed that an increased heart/liver ratio is suggestive of portal-caval shunting and portal hypertension. To evaluate the possibility of using thallium-201 as a test to diagnose cirrhosis, we administered this substance per rectum to 33 patients with biochemical evidence, but no clinical symptoms, of liver disease. Laparoscopy and liver biopsy revealed chronic active hepatitis without cirrhosis in 18 patients, and chronic active hepatitis with cirrhosis in the others. The results of conventional liver function tests were similar in both groups. A significant difference, however, was found between the means of fasting serum bile acid concentrations (9.8 +/- 3.2 and 18.3 +/- 4.2 microM per liter) in chronic active hepatitis without cirrhosis and cirrhotic patients, and between the means of the heart/liver ratios 20 min after thallium-201 administration (heart/liver: 0.09 +/- 0.03 and 0.54 +/- 0.13, respectively). Unlike the serum bile acid concentration which gave some overlapping values, the thallium-201 test clearly distinguished the chronic active hepatitis without cirrhosis group from the cirrhotics. In the cirrhotic group, there was a significant correlation between the heart/liver ratio and signs of portal hypertension such as esophageal varices, increased diameter of the vena porta and hypersplenism. The thallium-201 test is therefore useful in discriminating between chronic active hepatitis with and without cirrhosis in clinically asymptomatic subjects with biochemical evidence of moderate liver function impairment. A heart/liver uptake ratio much higher than normal (above 0.30) strongly suggests the development of hepatic cirrhosis.

Administration, Rectal↗
PubMedDate not supplied

Small bowel Crohn's disease: comparison of enteroclysis, bowel sonography and Tc-99m-HMPAO leukocyte scintigraphy.

BACKGROUND: Crohn's disease (CD) frequently involves the small bowel. Actually, the diagnosis of CD is made by ileocolonoscopy (IC) and small bowel enteroclysis (SBE), while trans-abdominal bowel sonography (BS) and Tc-99m-HMPAO leukocyte scintigraphy (LS) are only partially used in spite of their minimal invasiveness. AIM: to compare the diagnostic accuracy of these procedures for the diagnosis of small bowel CD. PATIENTS AND METHODS: in about two years a series of consecutive subjects underwent IC, SBE, BS and LS for either suspected or known small bowel CD. RESULTS: Sensitivity, specificity, positive and negative predictive value for CD diagnosis of the studied procedures were respectively: 98%, 97%, 98% and 97% for SBE; 92%, 97%, 98%, and 88% for BS; 90%, 93%, 96% and 85% for LS. In addition, the parallel combined use of BS and LS led to overall sensitivity, specificity, positive and negative predictive value of 100%, 93%, 96%, 100%, respectively. CONCLUSION: SBE, BS and LS are accurate procedures for the diagnosis of small bowel Crohn's disease. The use of BS and LS, particularly in combination, can be proposed as early diagnostic approach to subjects with a suspicion of disease.

Adolescent↗