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Biomedical subjects

M Salvatore

Publications and source records attributed to M Salvatore.

At least 235 records · Page 13Linked to original sources
PubMed1991

Relative protection from cerebral atherosclerosis of young patients with homozygous familial hypercholesterolemia.

It is well known that hypercholesterolemia is correlated with coronary atherosclerosis, but no definite information is available on its association with cerebrovascular atherosclerosis. We studied 10 young patients (age 3-32 years) with homozygous familial hypercholesterolemia (FH), together with 3 normal relatives as healthy controls. Extra- and intracranial Doppler examination, MRI and cerebral blood flow by SPECT and 99mTc-HM-PAO were performed on all. Six out of 10 patients already had signs and symptoms of coronary heart disease, but all patients were free from ischemic brain lesions, as small as detectable at MRI, and had normal cerebral blood flow. Two patients presented significant stenosis of the carotid arteries at Doppler examination. Young patients with homozygous FH have early and clinically evident coronary atherosclerosis, while overt disease in the cerebral district is delayed despite the extremely elevated plasma cholesterol concentration. This was also confirmed by the autopsy of two patients, who died after the study and whose cerebral arteries were totally free from atherosclerotic lesions. The age, at which flow-reducing atherosclerotic lesions develop in hypercholesterolemic patients, differs with regard to the arterial district involved.

Adolescent↗
PubMed1991

Clinical studies with B72.3 in ovarian cancer and probe-guided tumor localization.

The present study reports the findings of radiolabeled monoclonal antibody (MoAb) application in the post-operative monitoring of patients with ovarian carcinoma. We studied 40 patients with histologically confirmed ovarian cancer using two radiolabeled MoAbs, 131I-B72.3 and 131I-OC125. Antibody scans showed that high uptake of radiolabeled MoAb was consistently associated with presence of disease confirmed by computed tomography, ultrasonography, clinical evolution and in a few cases by second look procedures. Computed tomography could not discriminate well between post-operative fibrosis and tumor lesion especially when localized in the peritoneum. We conclude that radiolabeled MoAbs, computed tomography and serum tumor markers are complementary in the postoperative monitoring of patients with ovarian carcinoma.

Antibodies, Monoclonal↗
PubMed1991

Radiolabelled granulocytes in inflammatory bone disease.

Inflammatory lesions in 7 patients have been investigated using labelled in vivo granulocytes. Targeting of white cells was done with a monoclonal antibody, mouse IgG1 reacting with NCA (non-specific crossreacting antigen) and CEA (carcinoembryonic antigen) (BW 250/183) labelled with 99mTc. All inflammatory lesions were visualized, with excellent quality scintigram, between 3-6 and 24 h after the injection. Because the antibody can be stored in a freeze-dried form and labelled at any time with 99mTc without cell separation being necessary, the method appears to be suitable even for use in acute diagnosis.

Antibodies, Monoclonal↗
PubMed1991

Effect of acute administration of L-acetyl carnitine on cerebral blood flow in patients with chronic cerebral infarct.

The effect of L-acetyl carnitine (L-AC) on cerebral blood flow (CBF) was evaluated in 20 patients with chronic cerebrovascular disease, who suffered an ischaemic stroke at least 6 months before the study. All patients performed a CT scan and were investigated with xenon-133 by brain dedicated single photon emission computed tomography (SPECT, Tomomatic 32, Medimatic Inc., Copenhagen). A single high dose (1.5 g) of L-acetyl carnitine was intravenously administered to 10 patients, while sodium acetate as placebo was injected to 10 other subjects. Cerebral blood flow (ml/min x 100 g) was evaluated before and 45 min after the injection. No changes were observed after placebo injection (43 +/- 12 ml/min x 100 g versus 43 +/- 10 ml/min x 100 g). CBF increased (from 42 +/- 9 ml/min x 100 g to 46 +/- 9, P less than 0.05) in both ipsilateral and contralateral hemisphere, the ischaemic area, but not in the stroke corresponding zone. It was concluded that L-acetyl carnitine at the i.v. dosage of 1.5 g acutely enhanced CBF in patients with chronic cerebral infarct.

Acetylcarnitine↗
PubMed1991

Mixed transcortical aphasia: clinical features and neuroanatomical correlates. A possible role of the right hemisphere.

This paper reports the clinical features of 2 patients affected by mixed transcortical aphasia. Both of them had extensive damage of the left hemisphere. Cerebral blood flow measurement showed a marked decrease in left-hemisphere flow. In particular, speech areas were found to be morphologically and functionally damaged. The present findings, together with a critical review of the literature, served as a starting point for a discussion of linguistic features, diagnostic criteria and classical neuroanatomical interpretation of mixed transcortical aphasia. The possible contribution of the right hemisphere in determining this aphasic syndrome is suggested.

Aged↗
PubMed1991

Assessment of left ventricular diastolic function: comparison of contrast ventriculography and equilibrium radionuclide angiography.

Twenty-two patients with coronary artery disease were studied first by radionuclide angiography (RNA) and then by contrast ventriculography. Cardiac medications were discontinued at least 72 hr before study. The patients were studied during atrial pacing at heart rates close to their spontaneous sinus rhythm. Contrast ventriculography was performed at 50 frames/sec in the 30 degrees right anterior oblique projection using 40 ml of a nonionic contrast medium (iopamidol) at a flow rate of 10-12 ml/sec. The contours of the left ventricular silhouette at contrast ventriculography were traced, frame by frame, on a graphic table with a digitizing penlight. Equilibrium 99mTc RNA was performed in the best septal 45 degrees left anterior oblique projection, acquiring 150,000 cts/frame, at 50 frames/sec and with a 5% gate tolerance. Time-activity curves from both end-diastolic and end-systolic ROIs were built and interpolated. Both RNA and contrast ventriculography volume curves were filtered with Fourier five harmonics. A close relationship was found between RNA and contrast ventriculography measurements of peak filling rate normalized to end-diastolic cps (r = 0.87, p less than 0.001) and stroke count (r = 0.87, p less than 0.001), ejection fraction (r = 0.94, p less than 0.001). Thus, in patients with coronary artery disease, LV filling can be accurately assessed using RNA.

Algorithms↗
PubMed1991

[131I-meta-iodobenzylguanidine scintigraphy in patients with a suspected pheochromocytoma. A comparison with CT and biohumoral parameters].

The results of 131I metaiodobenzylguanidine (MIBG) and Computed Tomography (CT) scans in a group of patients with clinically suspected pheochromocytoma were evaluated and compared with biohumoral parameters. We studied 24 consecutive patients (7 M and 17 F; age range 20-66 years). 131I-MIBG scintigraphy and CT were in agreement in 19 patients (79%): of them 7 cases were true positive, and 12 were true negative. Disagreement between the two imaging techniques was observed in 5 patients (21%). In this group, one patient, with positive CT scan, had false negative MIBG study, while 4 patients with negative MIBG scan, had false positive CT. MIBG showed significantly higher (p less than 0.05) specificity (100%), positive predictive value (100%), and accuracy (96%) than CT (75%, 67%, and 83%, respectively). 131I-MIBG scintigraphy is an accurate, noninvasive technique for localizing pheochromocytoma and providing direct tissue characterization, while CT provides more accurate spatial information. In conclusion, CT and MIBG studies are complementary in the evaluation of patients with suspected pheochromocytoma.

3-Iodobenzylguanidine↗
PubMed1991

Relationship between urinary neopterin excretion and islet cell antibodies in type 1 (insulin-dependent) diabetes.

Neopterin is specifically produced by interferon-activated macrophages, and it may be considered a marker of cellular immunity. In 40 newly diagnosed and 38 longer standing type 1 (insulin-dependent) diabetics the relationship between urinary neopterin levels and islet cell antibodies (ICA) was investigated. Raised urinary neopterin levels were found in 30 ICA positive (mean +/- SD: 729.8 +/- 602.1 mumol/mol creatinine, p = 0.0001) and 10 ICA negative (433.4 +/- 191.2 mumol/mol creatinine, p = 0.0005) diabetics at onset of disease compared with age-matched control subjects (118.1 +/- 33.2 mumol/mol creatinine). No significant difference in urinary neopterin levels was observed between diabetic groups. After the first stages of disease (greater than 5 months from onset), a significant difference (p = 0.0002) in urinary neopterin excretion was found between longer standing ICA positive patients and controls, but not between ICA negative diabetics and controls. In longer standing diabetics, neopterin levels were significantly higher in ICA positive patients than in ICA negative patients (544.6 +/- 341.3 versus 201.7 +/- 180 mumol/mol creatinine, p = 0.0002). No correlation between newly diagnosed or longer standing patients and HbA1c levels was found. Our results suggest that increased neopterin excretion in type 1 diabetes seems to be a sensitive indicator for the activation of cell-mediated immunity even when ICA are undetectable.

Adolescent↗
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↗
PubMed1990

Effects of intravenous verapamil on left ventricular relaxation and filling in stable angina pectoris.

Left ventricular (LV) diastolic function is often impaired in coronary artery disease (CAD). To assess whether verapamil could improve LV diastolic properties, 12 patients with CAD undergoing right- and left-sided cardiac catheterization, as well as simultaneous radionuclide angiography, were studied before and during intravenous administration of verapamil (0.1 mg/kg as a bolus followed by 0.007 mg/kg/min). The heart rate was kept constant by atrial pacing in both studies. LV pressure-volume relations were obtained. Verapamil decreased LV systolic pressure (130 +/- 22 to 117 +/- 16 mm Hg, p less than 0.01) and the end-systolic pressure/volume ratio (2.4 +/- 1.3 to 1.6 +/- 0.5 mm Hg/ml, p less than 0.05), and increased LV end-diastolic (13 +/- 4 to 16 +/- 4 mm Hg, p less than 0.02) and pulmonary capillary pressures (10 +/- 5 to 12 +/- 5 mm Hg, p less than 0.005). Despite such negative inotropic effects, cardiac index increased (3.4 +/- 0.7 to 3.9 +/- 0.6 liters/min/m2, p less than 0.02). The time constant of isovolumic relaxation shortened (63 +/- 14 to 47 +/- 9 ms, p less than 0.02); peak filling rate increased (370 +/- 155 to 519 +/- 184 ml/s, p less than 0.001; 2.6 +/- 1.1 to 3.3 +/- 0.9 end-diastolic counts/s, p less than 0.02; and 4.1 +/- 1.6 to 5.5 +/- 1.5 stroke counts/s, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Quantitation of left ventricular asynchrony on radionuclide angiography phase images.

Quantitation of left ventricular (LV) asynchrony is relevant in clinical cardiology, as well as in evaluating LV mechanical properties. Radionuclide angiography (RA) phase images are extensively used, and asynchrony is usually assessed by computing the standard deviation of phase angle distribution (SD). However, SD is dependent on count statistics and does not take into account the spatial distribution of asynchrony. In this study a new index to evaluate asynchrony on phase images is presented (differential uniformity parameter, DUP). DUP is based on the frequency analysis of phase images. Diagnostic accuracy and reproducibility of either SD or DUP were tested. Reproducibility was evaluated in 15 patients studied by RA twice within a few minutes. DUP showed a better reproducibility than SD. Diagnostic accuracy was estimated in 84 patients, divided into four subgroups on the basis of coronary arteriography and contrast ventriculography findings: (a) 25 control subjects, (b) 16 patients with coronary artery disease (CAD) and normal LV wall motion, (c) 23 patients with CAD and LV hypokinesia and (d) 20 patients with CAD and LV dyskinesia. Relative diagnostic ability was assessed by comparing the areas under receiver-operating characteristic curves. DUP's area was larger than SD's when group D was tested against all the other groups (DUP's area = 87% +/- 5%, SD's area = 76% +/- 7%; P less than 0.01). Thus, our study indicates that DUP is more reproducible and more accurate than SD in identifying patients with CAD and LV dyskinesia.

Coronary Disease↗
PubMed1990

Phase analysis of radionuclide angiography in acute myocardial infarction.

Standard deviation of the histogram of left ventricular phase distribution (SDP-LV) obtained by radionuclide angiography (RNA) was studied in 75 acute myocardial infarction (AMI) patients, 37 with anterior or anteroseptal (Group A) and 38 with inferior, inferolateral or posterior necrosis (Group I). In order to evaluate sensitivity, specificity and accuracy of SDP-LV compared to ejection fraction (EF) and peak filling rate (PFR), 16 controls and 29 patients with coronary artery disease with normal kinesis proved by angiography were studied. Patients were also compared according to normal or abnormal EF and PFR. Sensitivity of PFR was better than those of EF and PFR (86.6% vs 38.7% and 70.6%, respectively). Specificity of SDP-LV was 89.6%, better than that of PFR (58.6%), but just less than that of EF (93.1%). The accuracy of SDP-LV turned out to be better than those of EF and PFR (87.5% vs 53.8% and 67.3%, respectively). Ejection fraction correlated with SDP-LV in the total study population (r = -0.54, P less than 0.001), and in Groups A (r = -0.44, P less than 0.01) and I (r = -0.43, P less than 0.05); SDP-LV correlated with PFR in the total population (r = -0.35, P less than 0.05), but not in Group A or I. Mean SDP-LV was higher in Group A than I and in patients with lower EF; no difference was found among patients with different PFR values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

The biological approach to radioimmunoscintigraphy.

The authors have analysed the theoretical and clinical implications of a biological approach to radioimmunoscintigraphy (RIS), a new diagnostic technique based on the in vivo reaction between radiolabelled monoclonal antibodies and tumor-associated antigens expressed by the neoplastic cells. The assumption is that, as in all radioisotopic procedures, the radioimmunoscintigraphic image is the expression of differences in concentration (and not in density) between adjacent tissues. This "biological premise" is analysed to demonstrate a possible role of RIS not only in diagnosis but also in prognosis and therapy. A comparison with other imaging procedures and with histopathology, considered as the "gold standard" of the present-day morphological approach to diagnosis, is also discussed. Finally, biological premises, as well as the initial results and prospects regarding the use of high doses of radiolabelled monoclonal antibodies for therapeutic purposes are presented.

Antibodies, Monoclonal↗
PubMed1990

Cerebral blood flow in patients with chronic cerebrovascular disease: effect of acetyl L-carnitine.

The effect of acetyl-L-carnitine on cerebral blood flow was evaluated in ten patients with cerebrovascular disease, who suffered an ischaemic stroke at least six months before the study. All patients performed a computerized tomograph scan and were investigated by Xenon 133 using a brain dedicated Single Photon Emission Computerized Tomography. Acetyl-L-carnitine was administered intravenously (i.v.) at a dosage of 1.5 g. Cerebral blood flow (ml/min. 100 g) was evaluated before and 45 min after the injection. Cerebral blood flow improved in both the ispilateral and controlateral hemisphere of the ischaemic area, but not in the stroke corresponding zone. It is concluded that acetyl-L-carnitine at a dosage of 1.5 g i.v. improves cerebral blood flow in patients with cerebrovascular disease.

Acetylcarnitine↗