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Biomedical subjects

M Salvatore

Publications and source records attributed to M Salvatore.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

Cardiological aspects of growth hormone and insulin-like growth factor-I.

In recent years it has been demonstrated that both GH deficiency and excess include in their advanced clinical manifestations an impaired cardiovascular function, which may reduce life expectancy. This observation has allowed the investigation of the role played by the GH/IGF-I axis on cardiac structure and function. In particular, several recent experimental and clinical studies support the evidence implicating GH and/or IGF-I in the regulation of heart development. Acromegalic cardiomyopathy is characterized by myocardial hypertrophy with interstitial fibrosis, lymphomononuclear infiltration and areas of monocyte necrosis which often result in increased right and left ventricular mass and concentric hypertrophy. Conversely, patients with childhood or adulthood-onset GH deficiency (GHD) have a reduced left ventricular mass and ejection fraction and the indexes of left ventricular systolic function remained markedly depressed during exercise. In addition, a significant increase in the thickness of the vascular intima-media wall and a higher number of atheromatous plaques have been reported. These abnormalities of the cardiovascular system are partially reversed after normalization of GH and IGF-I levels, by octreotide in acromegaly or after GH replacement therapy in GHD patients. The evidence that GH is able to increase cardiac mass suggested its use in the treatment of idiopathic dilated cardiomyopathy. In a recent study on such patients, the administration of rhGH was demonstrated to increase myocardial mass and to reduce the size of the left ventricular chamber, resulting in an improvement in hemodynamics, myocardial energy metabolism and clinical status. These promising results might open a new field for GH treatment.

Acromegaly↗
PubMedDate not supplied

Intrathecal radioisotopes and phlebography in investigation of ventriculo-atrial shunts in children.

The Authors describe their experience in investigating the functioning and patency of ventriculo-venous shunts in hydrocephalic patients. They examined 41 hydrocephalic children with Pudenz valves, with radioisotope techniques. The radioactive tracers were administered by the lumbar route, by the ventricular route, or directly into the shunt. For lumbar or ventricular administration 131I-HSA, 99mTc-HSA and 169Yb-DPTA were used, whilst 99mTCO4 was the only isotope used for direct introduction into the shunt, effected by piercing the pump of the Pudenz system. The results of these investigations show that introduction of the isotope into the shunt allows obtaining morphological information, depending on the patency of the shunt and on the site of any obstruction. It also provides information about the functioning of the shunt, depending on the presence of hyper- or hypo-shunting. In cases where revision of the distal catheter might be necessary, moreover, phlebographic investigations of the superior vena cava were made. These proved to be particularly useful for indicating the patency of the affluent veins of the heart, thus enabling a precise surgical schedule to be planned prior to operation.

Cerebrospinal Fluid Shunts↗
PubMedDate not supplied

[Ambulatory monitoring of left ventricular function with a radionuclide detector system].

The recent development of new radionuclide detectors allows noninvasive outpatient monitoring of left ventricular function. This study was aimed at describing a new radionuclide technique useful to monitor cardiac function and at evaluating its potential clinical applications. We studied 14 normal subjects, 30 patients with coronary artery disease and 25 patients with dilated cardiomyopathy. Left ventricular function was continuously monitored in control conditions at rest, during daily physical activity of different intensity (walking on a level surface and climbing stairs), and during bicycle exercise. Left ventricular ejection fraction (EF) variability during recording in control conditions at rest was 0.2 +/- 1.8%. A significant relationship between outpatient EF at rest and conventional equilibrium radionuclide angiography was observed (r = 0.97, n = 69, p less than 0.001). In normal subjects both daily physical activity and exercise stress test induced an increase in heart rate and EF. In patients with coronary artery disease and in patients with dilated cardiomyopathy a heterogeneous EF response was observed during physical activity and exercise stress test. Our results demonstrate that this technique can be used for the ambulatory monitoring of left ventricular function in both normal subjects and patients with different types of cardiomyopathies.

Adult↗
PubMedDate not supplied

[Magnetic resonance in the diagnosis and follow-up of soft-tissue sarcomas].

The authors analyze the advantages of MR imaging in the detection, staging and follow-up of malignant soft-tissue sarcomas. The role of MR imaging is retrospectively evaluated in 34 patients (16 men and 18 women) ranging in age from 3 to 82 years (mean: 38); 19 of them had a primary neoplasm, while the extant 15 patients were examined after surgery, and residual or recurrent tumors were present. Ten examinations were performed on an 0.5 T imager (CGR Magniscan 5000), and 27 were obtained with a 1.5 T system (Magnetom 42 SP Siemens). In all cases T1 and T2 sequences were acquired; in 3 patients T1-weighted sequences were performed after Gd-DTPA administration. In the 19 patients with primary tumors pathologic specimens were obtained. The value of MR imaging in the evaluation and characterization of soft-tissue sarcomas and its capabilities in detecting neurovascular encasement and bone involvement are discussed. Post-Gd-DTPA scans may help in the differentiation of necrotic areas from active tumors. MR diagnostic criteria of malignancy, including tissue heterogeneity and irregular margins, were not fulfilled in 3 of the studied cases.

Age Factors↗
PubMedDate not supplied

[Myocardial scintigraphy with technetium 99m methoxyisobutylisonitrile. A comparison with coronary arteriography in patients with suspected ischemic cardiopathy].

Technetium-99m methoxy-isobutyl-isonitrile (MIBI) myocardial scintigraphy has been proposed as an alternative to Thallium 201 myocardial imaging in the evaluation of patients with coronary artery diseases. We studied 39 patients (37 men, mean age 56 +/- 9 years) with suspected coronary artery disease. All patients underwent 99mTc MIBI myocardial scintigraphy after stress and at rest. Coronary arteriography, performed within 1 month, showed significant (greater than or equal to 50%) stenosis of at least 1 epicardial coronary artery in 36 subjects. 99mTc MIBI myocardial scintigraphy exhibited 94% sensitivity (34/36 patients) and 100% specificity (3/3 subjects with normal coronary arteries). Sensitivity for individual vessel stenosis was 81% (96% for the left anterior descending artery, 65% for the circumflex artery and 79% for the right artery). Our data show that 99mTc MIBI myocardial scintigraphy is capable of evaluating patients with coronary artery diseases.

Contrast Media↗
PubMedDate not supplied

[4'-epidoxorubicin: its cardiotoxicity. Possible cardiac protection with gallopamil, a drug with calcium-antagonist action].

The 4'-EPI-doxorubicin (4'-EDX) has shown antitumoral activity against a broad spectrum of human tumors. The same clinical reports have shown therapeutic activity comparable to doxorubicin (adriamycin), but a lower cardiac toxicity. 4'-EDX cardiotoxicity appears after highest cumulative doses: 935 mg/m2 bs for 4'-EDX vs 550 mg/m2 bs for adriamycin. Moreover we have observed a protective action of the calcium antagonist gallopamil. We have found an improvement in ventricular performance after using gallopamil, and a reduction of 4'-EDX cardiotoxicity. Cardiac function was evaluated by EKS, STI, echography, myocardial scintigraphy course. Our result indicates the possibility of treating tumors without serious cardiotoxic by 4'-EDX and gallopamil.

Adult↗
PubMedDate not supplied

[Evaluation of the arterial share of portal flow using a scintigraphic technique in patients with liver cirrhosis. Correlations with other parameters of portal hypertension].

This study aimed to measure in semiquantitative terms the arterial-venous ratio of the portal flow using a scintigraphic technique, by means of a simple intravenous injection of a 99mTcDiethylHIDA bolus, a method which was found to be extremely simple and non-invasive, with a good degree of repeatibility. The percentage of arterialisation of the portal flow was found to be higher in cirrhotic patients compared to non-hepatopathic subjects, and among cirrhotic patients it was correlated with the severity of disease, the presence and degree of esophageal varices, and the presence of porto-systemic shunts, assessed using the ammonium chloride test.

Adult↗
PubMedDate not supplied

Geometric mispositioning in positron emission tomography.

The phenomenon of geometric mispositioning (defined as having a geometric proper plus a parallax component) was studied and characterized on Neuro- and whole body PET systems employing 2-D modular detectors (CTI/Siemens ECAT-831/08 and 931/08) as well as an older system (CTI ECAT-911). Measurements taken with precisely spaced line sources showed image distortions of objects away from the center of the field of view (FOV), with global mispositionings of -1.4, 1.5 and 14 mm (931 and 911), and -0.5, 10 mm (831) at 10, 20 and 30 cm (931 and 911) and 10, 20 cm (831) from the center of the FOV. Structures as close as 5 cm (931/911) or 4 cm (831) to the center of the FOV are mispositioned by more than 1 mm. This is clearly inacceptable in cases where accurate correlation of PET and NMR images is needed to acquire anatomical information in neurological studies, or when gated cardiac studies are performed in order to precisely determine myocardial wall thickness. A fast, on-line geometric correction was performed by creating new, uniformly spaced sinograms to be mapped to the original sinograms. Geometric mispositioning was mathematically derived, while parallax mispositioning was estimated by a linear fit of the data partially corrected for sampling non-uniformity. Our correction technique can be easily tailored to any PET system available on the market.

Mathematics↗
PubMedDate not supplied

Evaluation of TAG-72 as a serum marker in ovarian and breast carcinoma.

Tumor Associated Glycoprotein 72 (TAG-72) is common to most epithelial tumors. In this study serum levels of TAG-72 were measured in 36 healthy female subjects, in 94 patients with breast cancer, and in 43 others with epithelial ovarian cancer. More particularly, 27 out of the 94 patients with breast cancer had early disease (Stage I-I; or T 0-2b; N 0-1b; M 0), while the remaining 67 had advanced disease (Stage III-IV; or T 0-4; N 0-3; M 0-1). All the 43 subjects with ovarian cancer were at stage III-IV (FIGO Classification), 12 of whom had minimal disease (lesions less than 2 cm) and the other 31 had bulky disease. 3.5 U/ml being the highest value found in the control group, we arbitrarily assumed 3.85 U/ml (mean +/- 3 SD) as the cut-off limit in this preliminary study. Among the patients with breast cancer, 17 out of the 67 subjects with advanced disease (25.3%) and 1 out of the 27 others with early disease (3.7%) exceeded the TAG-72 cut-off limit. Among the patients with ovarian cancer, 2 out of the 12 subjects with minimal disease (16.7%) and 22 out of the others 31 with bulky disease (70.9%) had TAG-72 levels above cut-off limit. High TAG-72 levels were found in all the histotypes of ovarian cancer including the mucinous type. Preliminary data seem to indicate that in ovarian cancer variations in serum levels of TAG-72 are in agreement with the trend of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Neoplasm↗