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Biomedical subjects

M Mele

Publications and source records attributed to M Mele.

At least 37 records · Page 2Linked to original sources
PubMed1989

[A new technic for esophago-enteral anastomosis with a mechanical stapler without purse-string sutures].

Staplers have improved the results of esophageal surgery, in our experience and in others experience, as esophago-enteric anastomoses have become safer and faster than when manual suturing is used. Probably one of the last problems in the stapler technique, especially in the thoracic area, is the performance of on adequate esophageal purse-string suture: an improper performance of this suture can cause a dangerous leak of the anastomosis. So, many surgeons, to reduce the risk of esophageal dehiscence connected with the esophageal purse-string, use either purse-string devices or alternative methods such as a second handsewn purse-string, U stitches of the esophagus, etc. We think that the risk of improper anastomoses after esophageal resection can be reduced if the need for the esophageal purse-string can be eliminated. This work shows our personal technique for performing esophagoenterostomy, especially in the thoracic area, using the new CEEA stapler (Autosuture) without esophageal purse-string sutures. According to the modified procedure the stapler anvil and the mini rod are introduced in the esophagectomy and a 2-0 thread is knotted around the CEEA mini rod. Then the esophageal mutilated part is closed by a linear stapler keeping a syringe needle, which contains the thread, through the linear suture. Then, using the thread as a pulling system, the surgeon makes the needle and the tip of the mini rod slide out of the esophageal suture. Now the surgeon can reassemble the CEEA and perform the anastomosis. There are many clinical reports that cite no leaks following circular stapled anastomoses across linear stapled closures.

Anastomosis, Surgical↗
PubMed1989

Clearance kinetics and fate of macromolecular IgA in patients with IgA nephropathy.

IgA glomerulonephritis is associated with macromolecules of polymeric IgA in the circulation and mesangial deposits. An impairment in the reticulophagocytic function of patients with IgA nephropathy has been postulated as the potential cause for persistence of IgA immune complexes in the circulation and their eventual glomerular deposition. Since the fate and removal mechanisms of circulating macromolecular IgA are unknown in humans, we examined the blood clearance and organ uptake of purified IgA polymers and macromolecules in patients with IgA nephropathy and normal controls. The IgA macromolecules were prepared by covalent cross-linking of purified human polymeric IgA with a heterobifunctional reagent, N-succinimidyl 3-(2-pyridyldithio) propionate. After intravenous injection, large IgA molecules were removed rapidly from the circulation of patients (t1/2 = 3.8 +/- 1.0 minutes) and controls (t1/2 = 4.9 +/- 1.5 minutes). Dynamic gamma camera scintigraphy revealed the liver as the major organ that mediated the removal of the macromolecular IgA with no significant difference in the rate of hepatic uptake for patients (t1/2 = 3.4 +/- 0.6 minutes) and controls (t1/2 = 3.3 +/- 0.9 minutes). No significant amount of radioactivity could be detected in the lungs, kidneys, and spleen. The small polymers had a slower and similar clearance rates for patients (t1/2 = 29.3 +/- 7.9 h) and controls (t1/2 = 29.0 +/- 8.6 h). These findings have general significance in showing the liver as a major organ for removal of macromolecular IgA. In addition, the results have specific importance in showing that patients with IgA nephropathy do not suffer from an IgA removal dysfunction.

Adolescent↗
PubMed1989

[Paresthetic notalgia. Report of 2 cases].

The Authors describe two cases of notalgia paresthesica, a disorder with localized pruritus of the back and hypesthesia for touch possibly due to a sensory neuropathy involving the posterior primary rami of thoracic nerve T2 through T6. The condition is not rare, but underdiagnosed for the poor clinical relevance. The possible X-linked hereditary transmission and other pathogenetic hypotheses are discussed.

Back↗
PubMed1988

The early diagnosis of idiopathic femoral osteonecrosis.

Idiopathic osteonecrosis of the femoral head presents many problems of diagnosis and treatment during the early stages of the disease due to the paucity of clinical manifestations and the absence of radiographic evidence. By the time that the radiographic and clinical evidence are sufficient for a reliable diagnosis, the disease is so advanced that treatment is a problem. Early diagnosis is therefore the key issue and, in this context, instrumental tests, CT scanning and the measurement of blood flow velocity play an ever-increasing role. In the early stages of the disease CT scanning shows characteristic changes in the socalled "asterisk sign" of Dihlmann, and this has proved useful not only in terms of diagnosis, but also in order to initiate early treatment of the disease. Although radioisotope methods with double tracer do not allow for direct visualisation of the circulation in the femoral head, they have proved to be extremely reliable in evaluating the perfusion index of the femoral heads by providing activity/time curves which are a reliable estimate of regional blood flow.

Blood Flow Velocity↗
PubMed1985

Renal perfusion in chronic liver diseases: evaluation by radiotechnetium renography.

Twenty-four patients with chronic liver diseases and seven normal controls were studied using renal and hepatic radiotechnetium angiography. The time-activity histograms generated were employed to calculate both the renal perfusion index (RPI) and the hepatic perfusion index (HPI). Renal perfusion proved to be reduced not only in cirrhotic patients but also in patients with aggressive chronic hepatitis, as well as in those with persistent chronic hepatitis. The HPI, which is to be considered as being strictly dependent on portal flow, only fell significantly in the group of cirrhotic patients. In all patients groups, the correlation coefficient between the HPI and RPI (mean of the two kidneys) was low (r = 0.275) and not significant (P greater than 0.05). After Warren's splenorenal derivation, renal perfusion did not improve but worsened, particularly in the left kidney where derivation anastomosis probably caused a venous overload.

Adolescent↗
PubMed1983

Computer analysis of Tc-99m DPD and Tc-99m MDP kinetics in humans: concise communication.

Technetium-99m DPD and Tc-99m(Sn)MDP were compared regarding the quality of skeletal images and the compartmental kinetic data, in two groups of nine normal subjects. No difference in scan quality was found. Data derived from compartmental kinetic analysis suggest that MDP has a higher bone uptake and a lower soft-tissue retention in comparison with DPD.

Adult↗
PubMedDate not supplied

Survival and dementia: a 7-year follow-up of an Italian elderly population.

The objective of this study was to investigate the association between dementia and mortality in an elderly Italian population. Demented subjects were identified by a previous prevalence study of Alzheimer's disease (AD) and specific dementing disorders. The study sample included all inhabitants of Appignano aged 60 and over (778 subjects), and was followed-up over a period of about 7 years. Periodic records of dates of death were obtained from the Registry Office of Appignano. We found considerably higher mortality ratios for subjects previously diagnosed as having dementia syndrome (12.5% at 1 year and 81.3% at about 7 years) than for those who were non-demented (3.0% at 1 year and 21.5% at about 7 years). In the group of demented subjects (N = 48), we also investigated the influence of sex, age, and specific dementing disorders on mortality ratios. The percentage of demented subjects who died during the whole period of follow-up was higher among men than women (100% vs. 66.7%) and increased considerably with increasing age (50.0% for age class 60-69, 76.5% for age class 70-79, and 86.2% for age class 80+). Mortality of subjects with multi-infarct dementia (MID) and mixed dementia (MD) tended to be slightly higher than in subjects affected by AD. Our results are consistent with those reported in previous population-based studies on survival of dementia patients.

Journal Article↗
PubMedDate not supplied

[Bicycle ergometry exercise tests: a comparison between 3 protocols with an increasing load].

A group of 26 male long-distance runners performed 3 cycle ergometer tests of progressively increasing intensity up to exhaustion. The tests were performed on 3 different days. The workload increased as follows: 30 Watts every 3 min (test I), 10 Watts every min (test II), and 30 Watts every min (test III). Ventilatory and gas exchange measurements were averaged every 30 sec during each test. The heart rate (HR) was monitored continuously by ECG. In each test the anaerobic threshold (AT) was determined using ventilatory and gas exchange indices (VE, VCO2, VE/VO2). The work load on exhaustion and power at AT were the same comparing test I with test II, but these values were significantly higher in the 30 Watts/1 minute test. Conversely, maximal oxygen uptake (VO2 max) and the VO2 observed at anaerobic threshold were comparable in the 3 protocols. The slopes of VO2, VCO2, VE and HR against the work load (Watts) were identical in test I and II, but were slower in test III. However, no differences in the ventilatory and heart rate patterns versus oxygen uptake were observed comparing the three exercise tests. These results suggest a good comparability between the 30 Watts/3 min test and the 10 Watt/1 min protocol. Furthermore, for workloads below AT, a steady state was attained at the 3rd minute of each phase during test I, while oxygen uptake and other cardio-respiratory variables were underestimated during the protocol in which phases of 30 Watts were maintained only for 1 minute.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

99mTc-pyrophosphate kinetics in man (relationship between bone uptake and mineral content).

Both the kinetics and the regional distribution of 99mTc-PPi were studied in the skeleton of healthy subjects of various ages by surface counting using a scintillation counter placed over different skeletal areas. The results were compared with bone mineral content as determined by the photonic absorption technique. Kinetic data of bone uptake were obtained by subtracting the counts measured in blood from the counts recorded over each body surface after making proportional corrections. The surface-counting patterns show a higher generalized 99mTc-PPi bone uptake in children and adolescents than in adults. The relative regional distribution of the tracer shows no difference between the two groups. The tracer accumulated more rapidly in spongy bone than in compact bone, and the fixation process was carried out during the first 30 min for both spongy and compact bone. In youths, however, higher uptake values corresponded to lower values of mineral content. The findings enable the normal surface-counting pattern to be constructed and confirm that the 99mTc-PPi uptake is related to bone metabolism; they also suggest the application of external measurements for the study of metabolic bone diseases.

Adolescent↗