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Biomedical subjects

M Gallucci

Publications and source records attributed to M Gallucci.

At least 109 records · Page 6Linked to original sources
PubMed1990

Endoscopic manipulation of ureteral calculi in children by rigid operative ureterorenoscopy.

To date, rigid operative ureterorenoscopy with ultrasound lithotripsy for the treatment of ureteral calculi has been performed only in adults or older children. The size of the instrument with the working channel for the ultrasound probe has been considered unsuitable for delicate anatomical structures, such as those of children younger than 4 years. We performed 8 ureterorenoscopic examinations in 7 patients (3 boys) 3 to 8 years old and have demonstrated that the 11.5F ureteroscope can be inserted without difficulty into the ureteral meatus of a 3-year-old boy. Introduction of the instrument is facilitated by the use of the Perez-Castro irrigation pump. This procedure does not lead to any urethral or ureteral damage, nor is vesicoureteral reflux shown on a postoperative cystogram. This technique allows extracorporeal shock wave lithotripsy to be extended also to small children, offering the possibility of easy and successful management of any residual steinstrasse.

Child↗
PubMed1990

Staghorn calculi of the kidney: classification and therapy.

Following the introduction of new techniques, the reclassification of staghorn calculi is indicated in order to establish the most suitable form of treatment. Of 269 patients with staghorn calculi treated over a 3-year period, 56% underwent extracorporeal shockwave lithotripsy (ESWL) monotherapy; 16% required open surgery and the remaining 28% underwent percutaneous nephrolithotripsy (PCNL) with ultrasound in association with ESWL. The latter group has been reviewed, taking into account invasiveness, results, complications and cost effectiveness. A combination of PCNL and ESWL was beneficial in patients in whom percutaneous access through a single tract removed more than 70% of the stone. As a result of these findings, the authors propose a revised classification of staghorn calculi.

Adolescent↗
PubMed1990

Magnetic resonance imaging in the localization of undescended abdominal testes.

In children with nonpalpable undescended testes, preoperative localization is very helpful prior to surgical investigation both to reduce the time required for complete exploration and to plan the correct surgical procedure. Magnetic resonance imaging (MRI) was accomplished in 23 patients with a clinical diagnosis of cryptorchidism after ultrasonographic studies were inconclusive in identifying the undescended testis. An abdominal testis was correctly located in 16 cases. No structures resembling testicular parenchyma were detected in 4 instances. The surgical findings confirmed the absence of testes in 2 patients but showed 2 abdominal testes not seen by MRI. The movements of 5 patients caused inadequate MRI examinations, so these patients were not considered in the results. In our experience MRI proved to be effective in locating undescended abdominal testes with a diagnostic accuracy of 90%. Therefore MRI should be performed before any invasive diagnostic procedure. Lack of cooperation in young patients could reduce the accuracy of the procedure, so we think that sedation should be performed in children under 6 years of age.

Abdomen↗
PubMed1990

Wernicke encephalopathy: MR findings in five patients.

Wernicke encephalopathy is a disease usually related to chronic alcoholism. The clinical diagnosis is often difficult to establish, and CT is unable to provide specific findings. MR follow-up studies in five patients affected by Wernicke encephalopathy were performed with the aim of establishing the sensitivity of MR in depicting the typical diencephalic/mesencephalic lesions. All subjects had MR imaging in the acute phase of the disease and were reexamined 6-12 months later, at which time they were in good health. Three of them also had CT scanning. On MR, hyperintense areas seen surrounding the third ventricle and aqueduct during the acute phase of the disease had disappeared or diminished on follow-up evaluations. The third ventricle and aqueduct were dilated. We suggest that these findings reflect the natural evolution of Wernicke encephalopathy. The MR findings in Wernicke encephalopathy enable early diagnosis of the disease, which has a positive effect on both treatment and prognosis.

Adult↗
PubMed1990

31P nuclear magnetic resonance spectroscopy study on kidney preservation. Effect of verapamil.

31P NMR spectroscopy has been used to evaluate the usefulness of verapamil, a calcium channel blocker, in preventing ischemic renal damage. Phosphorylated metabolites have been investigated before, during and after 48 hrs of hypothermic storage. The rapidity in adenosine triphosphate resynthesis and the phosphomonoesters and phosphodiesters levels after reperfusion at the end of the storage period (48 hrs), were significantly higher in verapamil-treated kidneys. Phosphomonoesters to inorganic phosphate ratio, during the storage period, is even higher. These findings suggest that verapamil may protect against ischemic renal damage and so it can be useful for renal preservation. Furthermore, it has been shown that 31P NMR spectroscopy puts into evidence the biochemical recovery and allows the assessment of the viability of organs.

Animals↗
PubMed1990

Sodium naproxen versus sodium diclofenac in cancer pain control.

In a single-blind random study, simultaneously carried out by five Pain Therapy and Palliative Care Centres, the analgesic power and side-effects of sodium naproxen (CAS 26159-34-2) and sodium diclofenac (CAS 15307-86-5) by mouth were compared in a group of 100 advanced cancer patients. The patients complained of somatic and/or visceral pain and were treated with non-steroid anti-inflammatories as required. The dose administered amounted to 550 mg every 12 h for sodium naproxen and to 100 mg every 12 h for sodium diclofenac. The study stressed the similar analgesic effect of the two drugs--pain intensity and duration decreased by half in the first week of treatment--and a comparatively low morbidity rate.

Aged↗
PubMed1990

[Clinically manifest or silent primary and secondary syringomyelia. The magnetic resonance findings].

The MR scans were retrospectively reviewed of 40 patients who had been diagnosed as having syringomyelia. Our results demonstrate that syringomyelia can be found in asymptomatic patients as well as in many with atypical symptomatology. Our study stresses MR efficacy in investigating this pathologic condition. As a matter of fact, MR allowed us to visualize the cavity, its extension, the eventual association with Arnold Chiari type-I malformation and/or syringobulbia. In all cases cord enlargement and the presence of septations could also be demonstrated. In most cases the possible pathogenesis of syringomyelia could also be supposed.

Adolescent↗
PubMed1989

Comparison of home and hospital care of advanced cancer patients.

Treatment and care of terminal cancer patients are conducted in different ways, according to the cultural, social, political and economical situations of the countries which have progressively adopted and developed them. In Italy there are no specialized structures such as "hospices" or the "palliative care units" like in the Anglo-Saxon world: the care of terminal cancer patients is carried out either in a general hospital or at their own home. In Milan and elsewhere there are home care teams in which doctors, nurses, social workers and volunteers, all work in connection with hospital structures. In this way, patients can receive specialized care for physical, psychological and social problems at home too. To evaluate costs and effectiveness of this program, a comparison was made between the home care and the conventional treatment carried out in general hospitals. Two groups of thirty terminal cancer patients have been studied: the first group was composed of hospital patients in Desio and the second one included patients cared for by the home care service organized by the Floriani Foundation and the Italian League against Cancer (Milan Section). We evaluated intensity and duration of pain, hours of sleep and hours of standing, sitting and lying, presence of side-effects, performance status and therapies. Data were also collected on the quality of life (Spitzer QLI), social and economical needs of the patients, type and quality of care, degree of awareness of the diagnosis by the patient and the family. This data were collected by the nurse who looked after the patient. Care costs were also quantified. The comparison between the two groups significantly favours the home care group as shown by the performance status after 2 weeks of care, the "health scale" and the Total index of the Spitzer QLI and in general the greater satisfaction of the care received. Home care produces results equivalent to those achieved in hospitals as far as clinical parameters are concerned. An approximate quantification of the costs shows that an average cost for a day's home care was about Lit. 52,500 as compared with Lit. 360,000 for a day's hospitalization.

Activities of Daily Living↗
PubMed1989

Hemispheric asymmetries and schizophrenia: a preliminary magnetic resonance imaging study.

A magnetic resonance imaging (MRI) study of 20 chronic schizophrenic outpatients (5 women and 15 men) and 20 healthy volunteers, individually matched for age and sex, was conducted. Schizophrenics showed a statistically significant lateral ventricular enlargement and smaller corpus callosum: brain ratio than controls. There were no statistically significant differences in hemispheric measurements between groups. Nevertheless, we found a wider right frontal width versus the left in the patient group but not in the control group, and more frontal protuberances in the right hemisphere in the patient group. Possible meanings and implications of these findings for a pathophysiological hypothesis are discussed.

Adult↗
PubMed1989

Neurological complications of Schoenlein-Henoch syndrome: contribution of MR to the diagnosis. Case report.

In the protean clinical pattern of the Schoenlein-Henoch syndrome the central and peripheral nervous system signs and symptoms are of most uncertain epidemiological importance and of most debatable physiopathological status. In the case reported the contribution of nuclear magnetic resonance to the diagnosis proved to be greater than that of computed tomography because it imaged the CNS lesions.

Adolescent↗
PubMed1989

[Magnetic resonance of the prostate: critical evaluation of diagnostic possibilities].

The authors retrospectively reviewed 140 MR examinations of the prostate to assess the presence of similar findings in the different patients affected with the same prostatic disease. In 35 patients with acute phlogosis, MR imaging showed enlargement of peripheral gland, with increased signal intensity on T2-weighted images, while reduced peripheral gland with low signal intensity was demonstrated in chronic phlogosis. Five patients presented roundish cystic lesions, with clear-cut outlines, clearly distinguishable from the surrounding parenchyma. Benign Prostatic Hyperplasia (BPH) was observed in 32 cases. 52% of them had multiple nodules with high signal intensity, 40% had hyperintense enlarged central glands, with no evidence of BPH nodules, and the remaining 8% presented single/multiple nodules with low signal intensity. In 56 patients with prostatic carcinoma the tumor extent ranged from 18-20 mm nodules to 5-6 cm masses with involvement of periprostatic adipose tissue or surrounding organs. The smallest lesions were always found in the peripheral gland and had low signal intensity on T2-weighted sequences. In spite of the different findings in the patients affected with BPH, the study proved MR imaging to be able to distinguish the various patterns of the different prostatic diseases.

Adolescent↗
PubMed1989

[MR characterization of breast pathology using inversion recovery sequence].

As yet, a valid tissue characterization of human breast diseases has not been possible with conventional MR techniques. On the basis of the experimental thesis according to which fibroadenomas and carcinomas have a slight, though significant, difference in T1 relaxation times, we employed specific inversion recovery sequences at the T null of the breast glandular and adipose tissues, to enhance the differences in the signal intensities of the various pathologies. We examined 16 (6 cystic dysplasias, 5 fibroadenomas, 3 carcinomas, and 1 phylloid fibroadenoma) selected patients with the above-mentioned sequences in addition to the routine T1- and T2-weighted spin echo sequences. The following conclusions were reached by evaluating the characteristic signal intensities: MR spin echo sequences allow solid lesions to be distinguished from cystic ones; MR inversion recovery sequences allow fibroadenomas to be distinguished from carcinomas with 88% accuracy.

Adenofibroma↗
PubMed1989

[Magnetic resonance of the shoulder: technic, anatomy ana clinical results].

MR imaging was employed in 232 patients with traumatic or degenerative lesions of the shoulder. MR diagnosis was compared with arthrotomic findings in 19 cases, and with arthroscopic results in 3 cases. MR technique is here presented and the choice of scanning planes is discussed, together with the sequences of image acquisition and with the features of the surface coil employed. Axial, sagittal, and coronal scans were used in all cases. Both sagittal and coronal planes were performed obliquely on the basis of precise anatomical structures. T1-weighted sequences were used for they are reliable in locating the various anatomical structures and efficient in defining the several different pathologic conditions. The role of T2-weighted sequences was complementary, and they were employed in selected cases only. A surface coil is presented with a particular configuration of easy clinical use and with such technical features as to allow reduced fields to be imaged, with good spatial resolution. MR imaging could demonstrate with equal accuracy both skeletal-cartilage components and capsulo-ligamentous structures, thus defining associated lesions and small tears. In both degenerative and traumatic lesions of the rotator cuff, MR imaging showed both extent and entity of the pathologic process, with high accuracy in defining the impingement syndrome. MR imaging allowed the depiction of the anterior and posterior glenoid labra, even without intraarticular contrast media. Moreover, MR imaging made it possible to recognize both fractures and degenerative processes within the glenoid labrum on the basis of their signal intensities. This preliminary experience allows the authors to conclude that MR imaging is an accurate and non-invasive diagnostic method for the study of traumatic lesions and of degenerative changes of the shoulder.

Adult↗
PubMed1989

[Optimization of the technic in the study of the upper abdomen using magnetic resonance. I. Artifact reduction].

Complete motion artifact suppression is possible in abdominal MR imaging with the simple optimization of sequence parameters, with no need for special softwares. The authors have studied the influence of sequence parameters modification on the signal/noise relation and on the presence of motion artifacts. The tested parameters included Repetition Time (TR), 150 to 2000 ms, Echo Time (TE), 20 to 120 ms, and the number of acquisitions, 2 to 16. In T1-weighted sequences, the major advantages were offered by the short TR and short TE association, with many acquisitions. Optimal signal/noise relation and complete motion artifact suppression were thus obtained. In T2-weighted sequences, TE values had to be changed according to the desired contrast enhancement, and the number of acquisitions could not be increased to more than 2 in order to keep the acquisition time short.

Abdomen↗
PubMed1989

[Magnetic resonance in the characterization of atherosclerotic lesions].

Fifty-one patients with occlusive and dilating vascular diseases were evaluated with MR imaging, using T1 and T2-weighted sequences and an 0.5 T superconducting magnet. Atheromatous plaques were detected in the carotids and on the aortic walls. Fatty lesions had high signal intensity on T1-weighted sequences and could be well distinguished from older thrombotic depositions which presented with medium signal intensity on T1-weighted scans and low signal on T2-weighted images. Thrombotic depositions in aneurysmal dilatation of the aorta and carotid arteries could be distinguished from patent internal lumen; inside them, areas of different signal intensity were demonstrated, which were related to the paramagnetic effect of hemoglobin degradation products (hemosiderin and methemoglobin).

Aorta, Abdominal↗
PubMed1988

Standardized magnetic resonance image intensity study in schizophrenia.

A magnetic resonance imaging (MRI) study of 12 chronic schizophrenic outpatients (4 females and 8 males) and 12 healthy volunteers, individually matched for age and sex, found a significantly larger ventricle-brain ratio and smaller corpus callosum area in schizophrenics than in controls. There were no statistically significant differences in the image intensity values between schizophrenic and healthy volunteer groups. However, there were more intragroup differences (left-right) of the image intensity values in the SE-30 sequence than in the SE-120 sequence in schizophrenics than in normals.

Adult↗