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Biomedical subjects

M Rossi

Publications and source records attributed to M Rossi.

852 records · Page 48Linked to original sources

[Assessment with magnetic resonance of laryngeal and oropharyngeal movements during phonation].

The latest MR units are provided with the Turbo-Field-Echo technique which permits gradient-echo imaging with very short TE and TR and is optimized to yield the highest possible image quality within a very short acquisition time--i.e., less than 5 seconds. This dynamic study was aimed at depicting normal laryngeal and oropharyngeal movements during maximal inspiration and the prolonged uttering of vowels, in both a normal and a loud voice. We examined 10 healthy volunteers (7 men and 3 women) with an 0.5-T superconductive unit (Gyroscan T5 III, Philips Medical System). We used Turbo-Field-Echo sequences with the following acquisition parameters: TR 12 ms, TE 6 ms, flip angle 30 degrees, 4 acquisitions, acquisition time: 5 seconds. A single coronal scan was acquired at the larynx, while a midsagittal scan and 2 coronal scans were acquired at the oropharynx. The volunteers were asked to breathe in long and deep, to prolong the emission of the vowel [i] during laryngeal studies and to prolong the emission of the fundamental vowels [a], [i] and [u] in a normal (50 db) and a loud (70 db) voice during oropharyngeal studies. The movements of true and false vocal cords were clearly depicted in all the volunteers, and the activity of the different anatomical structures of the oropharyngeal cavity (lips, tongue, hard and soft palate, pharynx and epiglottis) was also demonstrated. During vowel production in a loud voice, the vocal tract was enlarged at the oral cavity for the vowels [a] and [u] and at the pharynx for the vowel [i]. To conclude, fast MRI with midsagittal scans is the best imaging modality to study different vocal tract patterns during speech and can thus replace midsagittal radiography and xeroradiography in the study of vowel production.

Adult↗

[Cholecysto-colic fistula: laparoscopic treatment].

Cholecystocolic fistula is an unusual complication of biliary tract disease and it may defeat laparoscopic treatment. We recently was a patient who, while undergoing laparoscopic cholecystectomy, was found to have a fistula between the gallbladder and the transverse colon. The fistula was transected with a 3 cm endoscopic linear stapling device and uneventful laparoscopic cholecystectomy was performed. This report shows that, with increasing experience, no absolute contraindications exist to starting laparoscopic cholecystectomy by introducing the laparoscope.

Biliary Fistula↗

Cardiac troponin I in patients with hematologic malignancies.

BACKGROUND: The cardiac isoform of troponin I (cTnI) is a myofibrillar protein highly specific for myocardial injury. We used a recently developed new-generation immunoassay with high analytical sensitivity to measure cTnI in patients diagnosed with hematologic malignancies, before chemotherapy and after an intermediate cumulative dose of anthracyclines. We hypothesized that measurement of cTnI with this sensitive method would provide evidence of myocardial injury in these patients. METHODS: Sera from 115 individuals (60 healthy controls, 25 anthracycline-naive patients and 30 patients treated with intermediate cumulative doses of anthracyclines) were assessed for cTnI, creatine kinase MB (CKMB) mass and myoglobin. Radionuclide left ventricular ejection fraction (LVEF) was also determined. RESULTS: Using this sensitive assay, detectable concentrations of cTnl were measured in the healthy population [mean, 19.5 pg/ml, 95% confidence interval (CI) 13.5-25.5 pg/ml]. Anthracycline-naive patients had cTnI mean values (36.5 pg/ml, 95% CI 25.1-47.9 pg/ml) that were significantly (P < 0.01) greater than those in the control group. cTnI was significantly (P < 0.00001) increased in anthracycline-treated patients (76.4 pg/ml, 95% CI 67.0-85.8 pg/ml) compared with both the anthracycline-naive patients and the controls. CKMB, myoglobin and LVEF were within the normal range in all patients. CONCLUSIONS: These data provide evidence for cardiac involvement in patients with hematological malignancies before and during the course of anthracycline chemotherapy. They suggest that detection of myocardial injury may be facilitated by measurement of cTnI with a highly sensitive assay.

Adult↗

[Non-invasive nasal ventilation in a a case of hypercapnic coma].

Noninvasive positive pressure ventilation (NPPV) via nasal mask is well known to be effective in the treatment of acute respiratory failure (ARF) secondary to chronic obstructive pulmonary disease (COPD). A case of ARF with hypercapnic coma due to exacerbation of COPD is described. Six hours of conservative therapy with oxygen and medical treatment did not show any result. As endotracheal intubation (ET) was avoided on the basis of advanced age, poor life expectancy of the patient and family wish, NPPV was set up using a pressure triggered ventilator. After 61 hours of uninterrupted NPPV, the acid-base alteration and the lethargic status was fully reversed. The conclusions is drawn that NPPV may be useful also in the treatment of patients affected by severe decompensated hypercapnic respiratory failure in whom ET is not indicated.

Aged↗

[Gastric cancer. Which resection?].

BACKGROUND: The choice of surgical technique in antral gastric cancer is still debated. Some authors support total gastrectomy in all cases. In recent years there is a trend to use total gastrectomy only if strictly necessary. Total gastrectomy allows a large lymph node excision, with better oncological results. The mortality rate and post-operative complications are quite similar today after gastric resection. Anyway, if exact histological diagnosis is possible and at least 6 cm unaffected tissue is preserved, oncological cure is possible by gastric resection. METHODS: Personal experience in 224 patients operated on from 1975 to 1994 is reported. RESULTS AND CONCLUSIONS: 54.3% had antral gastric cancer, 16.5% body cancer and 8.7% fundus gastric cancer. Subtotal gastric resection should be the surgery of choice in antral gastric cancer. Early subtotal gastrectomy with R2, Advanced (III and IV-TNM) only resection with R2, and Advanced (II-TNM) total gastrectomy with R3.

Aged↗