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1.
Arch Environ Contam Toxicol ; 66(4): 471-81, 2014 May.
Article in English | MEDLINE | ID: mdl-24258876

ABSTRACT

The aim of the study was to evaluate the airborne contamination by polycyclic aromatic hydrocarbons (PAHs) and some heavy metals (arsenic [As], cadmium [Cd], chromium [Cr], copper [Cu], nickel [Ni], lead [Pb], and zinc [Zn]) of different pollution scenarios around a solid-waste landfill in central Italy using the lichen Pseudovernia furfuracea as a monitoring tool. For this purpose, eight stations around a landfill characterized by different air pollution sources (industrial, agricultural, residential areas, and roads with different traffic intensities), together with three stations far from the landfill (control areas), were monitored using a set of 22 lichen samples (11 samples analysed for PAHs and metals after 4 months, and 11 samples analysed for metals after 8 months). After 4 months of exposure, the lichen content of all of the analysed elements was greater than that in the pre-exposed lichens. In addition, the Cu and Pb concentration after 8 months was greater than the level after 4 months. The order of metal concentration was Zn > Pb > Cu (or Cu > Pb) > Cr > Ni > As > Cd in all cases. The range of ∑11PAHs concentration was 634-1,371 ng/g dw (three to seven times greater than the amount in the pre-exposed lichens). The ∑11PAHs were dominated (>70 %) by compounds with three aromatic rings. The comparison of the levels of air pollutants among the monitored stations shows nonrelevant spatial patterns between the landfill stations and the control areas; the levels of PAHs and metals found in the lichen samples around the landfill seemed to be more related to the general diffusion of these pollutants in that area.


Subject(s)
Air Pollutants/analysis , Environmental Monitoring/methods , Lichens/chemistry , Metals/analysis , Polycyclic Aromatic Hydrocarbons/analysis , Air Pollution/statistics & numerical data , Italy , Refuse Disposal , Waste Disposal Facilities
2.
Environ Res ; 125: 69-74, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23477569

ABSTRACT

Atmospheric mercury emissions from mine-waste enriched soils were measured in order to compare the mercury fluxes of bare soils with those from other soils covered by native grasses. Our research was conducted near Mt. Amiata in central Italy, an area that was one of the largest and most productive mining centers in Europe up into the 1980s. To determine in situ mercury emissions, we used a Plexiglas flux chamber connected to a portable mercury analyzer (Lumex RA-915+). This allowed us to detect, in real time, the mercury vapor in the air, and to correlate this with the meteorological parameters that we examined (solar radiation, soil temperature, and humidity). The highest mercury flux values (8000ngm(-2)h(-1)) were observed on bare soils during the hours of maximum insulation, while lower values (250ngm(-2)h(-1)) were observed on soils covered by native grasses. Our results indicate that two main environmental variables affect mercury emission: solar radiation intensity and soil temperature. The presence of native vegetation, which can shield soil surfaces from incident light, reduced mercury emissions, a result that we attribute to a drop in the efficiency of mercury photoreduction processes rather than to decreases in soil temperature. This finding is consistent with decreases in mercury flux values down to 3500ngm(-2)h(-1), which occurred under cloudy conditions despite high soil temperatures. Moreover, when the soil temperature was 28°C and the vegetation was removed from the experimental site, mercury emissions increased almost four-fold. This increase occurred almost immediately after the grasses were cut, and was approximately eight-fold after 20h. Thus, this study demonstrates that enhancing wild vegetation cover could be an inexpensive and effective approach in fostering a natural, self-renewing reduction of mercury emissions from mercury-contaminated soils.


Subject(s)
Air Pollutants/analysis , Mercury/analysis , Mining , Poaceae/metabolism , Soil Pollutants/analysis , Waste Products/analysis , Biodegradation, Environmental , Environmental Monitoring/statistics & numerical data , Italy , Mercury/metabolism , Soil Pollutants/metabolism , Sunlight , Temperature
3.
Eur Radiol ; 23(2): 513-20, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22875158

ABSTRACT

OBJECTIVE: To evaluate whether apparent diffusion coefficient (ADC) values can predict the status of MGMT of glioblastoma multiforme (GBM) and correlate with overall survival (OS) and progression-free survival (PFS). METHODS: This retrospective study included 47 patients with pathologically proven glioblastoma. All of them underwent MR DWI study before surgery (mean time 1 week) and the status of methylguanine-DNA-methyltransferase (MGMT) promoter methylation was searched for. Minimum apparent diffusion coefficient (ADC) values were evaluated. OS and PSF parameters were calculated, and Student's t-test, Kaplan-Meier curves, linear and Cox regression were performed. RESULTS: Twenty-five patients showed positive methylation of the MGMT promoter. Patients showing MGMT promoter methylation had higher minimum ADC values, and they survived longer than those without MGMT promoter methylation. The median ADCmin value of 0.80 represents the cutoff value able to distinguish between methylated and un-methylated patients. Patients showing minimum ADC values higher than 0.80 survived longer than patients with minimum ADC values lower than 0.80. A linear correlation between minimum ADC values vs. the OS and PFS was observed. CONCLUSIONS: Minimum ADC values in glioblastoma multiforme could be used as a preoperative parameter to estimate the status of MGMT promoter methylation and the survival of patients.


Subject(s)
Brain Neoplasms/diagnosis , Brain Neoplasms/mortality , DNA Modification Methylases/genetics , DNA Repair Enzymes/genetics , Diffusion Magnetic Resonance Imaging/methods , Glioblastoma/diagnosis , Glioblastoma/mortality , Tumor Suppressor Proteins/genetics , Adult , Aged , Aged, 80 and over , Analysis of Variance , Brain Neoplasms/genetics , Cohort Studies , DNA Methylation , Disease-Free Survival , Female , Gene Expression Regulation, Neoplastic , Glioblastoma/genetics , Glioblastoma/therapy , Humans , Male , Middle Aged , Multivariate Analysis , Prognosis , Promoter Regions, Genetic , Proportional Hazards Models , ROC Curve , Retrospective Studies , Risk Assessment , Survival Analysis
4.
Sci Total Environ ; 448: 151-62, 2013 Mar 15.
Article in English | MEDLINE | ID: mdl-23098675

ABSTRACT

An oceanographic cruise campaign on-board the Italian research vessel Urania was carried out from the 26th of August to the 13th of September 2010 in the Eastern Mediterranean. The campaign sought to investigate the mercury cycle at coastal and offshore locations in different weather conditions. The experimental activity focused on measuring mercury speciation in both seawater and in air, and using meteorological parameters to estimate elemental mercury exchange at the sea-atmosphere interface. Dissolved gaseous mercury (DGM), unfiltered total mercury (UTHg) and filtered total mercury (FTHg) surface concentrations ranged from 16 to 114, 300 to 18,760, and 230 to 10,990pgL(-1), respectively. The highest DGM, UTHg and FTHg values were observed close to Augusta (Sicily), a highly industrialized area of the Mediterranean region, while the lowest values were recorded at offshore stations. DGM vertical profiles partially followed the distribution of sunlight, as a result of the photoinduced transformations of elemental mercury in the surface layers of the water column. However, at some stations, we observed higher DGM concentrations in samples taken from the bottom of the water column, suggesting biological mercury production processes or the presence of tectonic activity. Moreover, two days of continuous measurement at one location demonstrated that surface DGM concentration is affected by solar radiation and atmospheric turbulence intensity. Atmospheric measurements of gaseous elemental mercury (GEM) showed an average concentration (1.6ngm(-3)) close to the background level for the northern hemisphere. For the first time this study used a numerical scheme based on a two-thin film model with a specific parameterization for mercury to estimate elemental mercury flux. The calculated average mercury flux during the entire cruise was 2.2±1.5ngm(-2)h(-1). The analysis of flux data highlights the importance of the wind speed on the mercury evasion from sea surfaces.


Subject(s)
Air , Atmosphere/chemistry , Environmental Pollutants/analysis , Mercury/analysis , Seawater/chemistry , Environmental Monitoring/methods , Environmental Pollutants/chemistry , Mediterranean Sea , Mercury/chemistry , Phase Transition
5.
Radiol Med ; 117(3): 445-60, 2012 Apr.
Article in English | MEDLINE | ID: mdl-21892719

ABSTRACT

Magnetic resonance imaging (MRI) with a dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) sequence to study brain tumours provides information on the haemodynamic characteristics of the neoplastic tissue. Brain perfusion maps and calculation of perfusion parameters, such as relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV) and mean transit time (MTT) allow assessment of vascularity and angiogenesis within tumours of the central nervous system (CNS), thus providing additional information to conventional MRI sequences. Although DSC-PWI has long been used, its clinical use in the study of brain tumours in daily clinical practice is still to be defined. The aim of this review was to analyse the application of perfusion MRI in the study of brain tumours by summarising our personal experience and the main results reported in the literature.


Subject(s)
Brain Neoplasms/pathology , Magnetic Resonance Angiography/methods , Brain Neoplasms/physiopathology , Cerebrovascular Circulation , Contrast Media , Hemodynamics , Humans , Perfusion
6.
Eur Radiol ; 19(12): 2798-808, 2009 Dec.
Article in English | MEDLINE | ID: mdl-19533147

ABSTRACT

The purposes of this study were (1) to evaluate the possible identification of trajectories of fibre tracts, (2) to examine the useful of a neuronavigation system for presurgical planning, (3) to assess pre- and post-surgery patients' clinical condition and (4) to evaluate the impact of this information on surgical planning and procedure. Twenty-eight right-handed patients were prospectively and consecutively studied. All the patients were clinically assessed by a neurologist in both pre- and postsurgical phases. Separately the pyramidal tract, optic radiation and arcuate fasciculus were reconstructed. The trajectories were considered suitable for surgical planning if there were no interruptions of any of the layers at the level of the lesion. Dedicated software 'merged' the acquired images with the tractographic processing, and the whole dataset was sent to the neuronavigation system. The assessment of the 37 visualised trajectories close to the tumour resulted in a modification of the surgical approach to corticotomy in six patients (21%); the impact on the definition of the resection margins during surgery was 64%(18 cases). The overall impact percentage on the surgical procedure was 82%. In 27 cases, the symptoms had not changed. MR-tractography provides the neurosurgeon with a new anatomical view that has an impact on the surgical resection planning for brain neoplasms.


Subject(s)
Brain Neoplasms/pathology , Brain Neoplasms/surgery , Diffusion Tensor Imaging/methods , Neuronavigation/methods , Surgery, Computer-Assisted/methods , Adult , Aged , Female , Humans , Male , Middle Aged , Preoperative Care/methods , Reproducibility of Results , Sensitivity and Specificity , Treatment Outcome
7.
Clin Ter ; 160(2): 125-7, 2009.
Article in English | MEDLINE | ID: mdl-19452101

ABSTRACT

Posterior cerebral artery (PCA) territory infarcts account for only 5-10% of all infarcts in stroke registries. Moreover, the clinical features and etiology of such infarcts have not been studied as extensively as those in other vascular territories.We describe two patients with recurrent episodes of visual symptoms and headache due to probable transitory PCA vasospasm. MR angiography in the acute phase revealed incomplete visualization of PCA, conventional MRI showed mild T2 signal alterations and MR perfusion showed the presence of marked hypoperfusion in the same regions. Diffusion weighted MR images were normal. All these findings resolved after therapy. These cases suggest that reversible signal alterations associated with reversible vessel and perfusion abnormalities may be observed in patients with visual symptoms and headache. Normal DWI-MR may help distinguish these patients from those affected by non-reversible ischemic attacks.


Subject(s)
Headache/etiology , Infarction, Posterior Cerebral Artery/pathology , Magnetic Resonance Imaging , Vasospasm, Intracranial/pathology , Vision Disorders/etiology , Acute Disease , Adult , Aged , Anticoagulants/therapeutic use , Clopidogrel , Diagnosis, Differential , Diffusion Magnetic Resonance Imaging , Female , Hemianopsia/etiology , Heparin/therapeutic use , Humans , Infarction, Posterior Cerebral Artery/complications , Infarction, Posterior Cerebral Artery/drug therapy , Magnetic Resonance Angiography , Male , Migraine Disorders/diagnosis , Nimodipine/therapeutic use , Recurrence , Ticlopidine/analogs & derivatives , Ticlopidine/therapeutic use , Vasodilator Agents/therapeutic use , Vasospasm, Intracranial/complications , Vasospasm, Intracranial/diagnosis , Vasospasm, Intracranial/drug therapy
8.
Sci Total Environ ; 407(2): 917-24, 2009 Jan 01.
Article in English | MEDLINE | ID: mdl-18952256

ABSTRACT

It is well established that the dissolved gaseous mercury (DGM) production in waters is mainly driven by photochemical processes. The present paper provides evidence for a significant bacteria-mediated DGM production, occurring also under dark conditions in environmentally different types of coastal water bodies of the Mediterranean basin. The DGM production was laboratory determined in sea, lagoon-brackish and lake water samples, comparing the efficiency of the DGM production processes in darkness and in the light. This latter condition was established by exposing samples at solar radiation intensity in the Photosyntetical Active Radiation region (PAR) of 200 W m(-2). Mercury reduction rate in the dark was of the order of 2-4% of the DGM production in lightness, depending on the total mercury concentration in the water, rather than the bacterial abundance in it. Support for the active bacterial role in mercury reduction rate under dark conditions was provided by: 1) absence of significant DGM production in sterilized water samples (following filtration treatment or autoclaving), 2) restored DGM production efficiency, following re-inoculation into the same water samples of representatives of their bacterial community, previously isolated and separately cultured. Notwithstanding the low bacteria-mediated vs. the high photo-induced DGM production, whatever natural water body was considered, it is worth stressing the significant contribution of this organismal-mediated process to oceanic mercury evasion, since it occurs continuously along the entire water column throughout the 24 h of the day.


Subject(s)
Bacteria/metabolism , Darkness , Environmental Monitoring , Gases/metabolism , Mercury/metabolism , Water Microbiology , Water Pollutants, Chemical/metabolism , Bacteria/drug effects , Bacteria/growth & development , Bacteria/radiation effects , Mediterranean Sea , Mercury/radiation effects , Mercury/toxicity , Solubility , Time Factors , Water Pollutants, Chemical/radiation effects , Water Pollutants, Chemical/toxicity
9.
Neuroradiol J ; 21(2): 239-43, 2008 Apr 07.
Article in English | MEDLINE | ID: mdl-24256833

ABSTRACT

We describe a 32-year-old woman who presented with progressive dorsal back pain. Neither sensory nor motor deficit was reported. Magnetic resonance imaging (MRI) of the dorsal spine revealed a primary intradural extramedullary lesion with severe spinal cord compression. No other lesion was found in the central nervous system. During surgery an intradural extramedullary tumor was found without medullary infiltration and a total removal was achieved under microscopic guidance. The histological diagnosis revealed a benign extramedullary ependymoma. The patient recovery completely after surgery and at a follow-up of 24 months MRI showed no evidence of tumor recurrence. Ependymoma should be taken in account in the differential diagnosis on intradural extramedullary tumours.

10.
Radiol Med ; 112(6): 906-920, 2007 Sep.
Article in English, Italian | MEDLINE | ID: mdl-17891343

ABSTRACT

PURPOSE: This study was conducted to assess the possibility of identifying precise white matter tracts situated in proximity to intracranial tumours, to define the anatomical and topographical relations between the same white matter tracts and the tumour, to verify the possibility of integrating tractographic images in the context of a package of three-dimensional anatomical images to send to the neuronavigation system, to assess the impact of this information on surgical planning, and to analyse, both pre-and postoperatively, the patient's clinical conditions as an index of the functional integrity of the fibres themselves. MATERIALS AND METHODS: Twenty-five patients underwent diffusion tensor study prior to neurosurgery. With the use of dedicated software, relative colour maps were obtained and the trajectories of the white matter tracts adjacent to the tumour were reconstructed in three dimensions. These were then processed for preoperative planning. Planning, which was performed with the neuronavigator, was based on analysis of the location of the course of the main white matter tracts adjacent to the lesion (pyramidal tract, optic radiation and arcuate fasciculus). Two neurosurgeons were asked whether the tractography images had modified the access and/or intraoperative approach to the tumour. All patients were clinically assessed both pre-and postoperatively 1 month after the procedure to define the presence of symptoms related to the involvement of the white matter tracts studied and therefore to assess the integrity of the fibres after the operation. RESULTS: In one patient, the tumour was situated away from all the tracts studied and did not compress them in any way. Overall, 40/75 tracts studied had no anatomical relation with the tumour, were not displaced by the tumour or could not be visualised in their entire course. Analysis of the remaining 35 white matter tracts led to an a priori change in the surgical approach for corticotomy in four patients (16%), with no disagreement between the two neurosurgeons and an impact on the extent of resection during surgery in 17 (68%), thus an overall impact on the surgical procedure in 80% of cases. Eight patients showed no symptoms related to the involvement of the white matter tracts studied. In the remaining 17 patients, the symptoms were related to involvement of the pyramidal tract, arcuate fasciculus or optic radiation. At 1-month follow-up, one previously asymptomatic patient reported a speech disorder (transcortical sensory dysphasia); in the remaining 24, symptoms remained unchanged, with a tendency to improvement in 14/17 with symptoms related to involvement of white matter tracts studied. CONCLUSIONS: Magnetic resonance (MR) tractography offers the neurosurgeon an anatomical panoramic view that can improve surgical planning for the resection of intracranial tumours. Despite the high incidence of cases in which the lesion is responsible for changes that hinder the reconstruction of white matter tracts, the technique can change the surgical approach for corticotomy, defines the extent of resection and leads to some change in the procedure in 80% of cases. The improvement of pre-existing symptoms and the absence of new symptoms in the postoperative phase, in our opinion, confirms the value of the technique.


Subject(s)
Brain Neoplasms/pathology , Diffusion Magnetic Resonance Imaging , Brain Neoplasms/diagnosis , Brain Neoplasms/surgery , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Neuronavigation
11.
Anal Chim Acta ; 589(2): 269-74, 2007 Apr 25.
Article in English | MEDLINE | ID: mdl-17418191

ABSTRACT

The residue profiles of boldenone (17beta-Bol), its epimer (17alpha-Bol) and the related compound androsta-1,4-diene-3,17-dione (ADD), were investigated by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in urine of male calves orally treated with boldenone, boldenone esters, and/or ADD. In all the experiments with the administered steroids residues of 17alpha-Bol decreased rapidly after end of treatment; detectable amounts of 17alpha-Bol were however noticed along the withdrawal observation period after end of treatment. Differently, residues of 17beta-Bol were detectable only shortly after administration. This in vivo research concerning oral treatments of cattle with boldenone related substances proves ADD to be a very active boldenone precursor in bovine animals.


Subject(s)
Anabolic Agents/urine , Testosterone/analogs & derivatives , Administration, Oral , Anabolic Agents/administration & dosage , Animals , Cattle , Chromatography, Liquid/methods , Male , Tandem Mass Spectrometry/methods , Testosterone/administration & dosage , Testosterone/urine
12.
Anal Chim Acta ; 586(1-2): 171-6, 2007 Mar 14.
Article in English | MEDLINE | ID: mdl-17386709

ABSTRACT

The residue profiles of 17alpha-/17beta-boldenone conjugated (17alpha/beta-Bol) and ADD were investigated by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in urine of male veal calves fed two commercial milk replacers, with different content of cholesterol and phytosterols. The urine samples were collected within 4 h after feeding and further from all the animals. Detectable amounts of 17alpha-Bol conjugated were measured in urine collected from all calves, but the concentrations of 17alpha-Bol were higher in urine from calves receiving the milk replacer with the greater amount of phytosterols. During the whole experiment, 17beta-Bol and ADD were never detected in urine samples collected.


Subject(s)
Anabolic Agents/analysis , Anabolic Agents/urine , Animal Feed , Chromatography, Liquid/methods , Mass Spectrometry/methods , Milk/chemistry , Testosterone/analogs & derivatives , Animals , Calibration , Cattle , Diet , Male , Models, Chemical , Phytosterols/chemistry , Sterols/chemistry , Testosterone/analysis , Testosterone/urine , Time Factors
13.
Neuroradiol J ; 20(1): 56-60, 2007 Feb 28.
Article in English | MEDLINE | ID: mdl-24299590

ABSTRACT

Sporadic Creutzfeldt-Jacob disease (CJD) is a transmissible, progressive, fatal spongiform encephalopathy. Routine MR imaging sequences may show abnormalities in the basal ganglia and cerebral cortex. Recently, several reports claimed that diffusion weighted MRI (DWI) could demonstrate early brain lesions in CJD patients when conventional MR images are normal on T2-weighted sequences. We evaluated the usefulness of DWI, perfusion-weighted MRI (PWI) and spectroscopy to confirm the clinical diagnosis and assess lesion progression in two patients with suspected CJD. We noted a diffuse hypoperfusion in the basal ganglia where ADC values were reduced but spectroscopy values were normal. A strong hypoperfusion was observed in the right head of the caudate nucleus in patient n° 2 where spectroscopy values were abnormal. A typical distribution of hypoperfusion followed the posterior progression of disease. We suggest the hypoperfusion in the areas presenting restricted diffusion probably reflects spongiform degeneration and moderate mass effects from cytotoxic edema.

14.
Ann Plast Surg ; 56(3): 256-62, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16508354

ABSTRACT

The authors present their experience with the correction of deformities of the nasal saddleback using rib cartilage grafts. They present a review of international literature on this topic, analyzing 33 patients selected from 452 cases of rhinoplasties performed between January 1990 and December 2004 at the Department of Plastic and Reconstructive Surgery of the University of Rome "Tor Vergata." Nasal saddleback is one of the most complicated defects to correct surgically. It can be a consequence of nasoethmoid-orbital fractures and is in this case associated with other evident signs like telecanthus, teleorbitism, or orbital dystopia. It can be also a consequence of surgical procedures in the nasal area where a loss of bone or septal cartilaginous support has occurred. They compare the techniques employed in the reconstruction and describe the advantage of the use of cartilage from the 11th rib and evaluate the results of an engineering analysis of tension forces on the rib cartilage. Of the total number of patients treated, good cosmetic results were obtained in 84% of the cases and excellent functional results in almost all of the cases (94%).


Subject(s)
Cartilage/transplantation , Nose Deformities, Acquired/surgery , Rhinoplasty/methods , Adult , Esthetics , Follow-Up Studies , Graft Rejection , Graft Survival , Humans , Male , Nose Deformities, Acquired/diagnosis , Patient Satisfaction , Ribs/transplantation , Risk Assessment , Transplantation, Autologous , Treatment Outcome
15.
Environ Technol ; 26(11): 1303-8, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16335606

ABSTRACT

A fully automatic device for continuous analysis of DGM (Dissolved Gaseous Mercury) concentration in natural waters, controlled by a Notebook, with a resolution time of 10-15 min, equipped with an Atomic Absorption Spectrometer with a detection limit of 0.5 pg, is described. A particular feature of this instrument is the portability, making its use suitable in remote locations by means of a car battery. Comparison of the results obtained using the device in the continuous mode and in the discrete mode shows good agreement taking into consideration that water samples were collected with shifting sampling times. To compare samples collected at the same time, a second analytical device, running in the discrete mode, was used. In this case results show that measurements performed with the discrete mode are slightly higher than the continuous one. Avoiding the sample handling it was possible to reduce the contamination from external sources and to achieve low instrumental blank values (1-2 pg). The field performance of this portable instrument was tested on seawater and lagoon water, where the DGM daily behaviour was measured. In agreement with several authors, a time shifting between DGM and solar radiation intensity higher than the instrumental resolution time was noted.


Subject(s)
Environmental Monitoring/instrumentation , Environmental Monitoring/methods , Mercury/analysis , Water Pollutants, Chemical/analysis , Spectrophotometry, Atomic/methods
16.
Interv Neuroradiol ; 9(3): 249-54, 2003 Sep 30.
Article in English | MEDLINE | ID: mdl-20591250

ABSTRACT

SUMMARY: Two Landrace Large White swine underwent angiography by the femoral route. In both cases, the superior left renal artery was embolized by injection of 2 ml of Glubran 2((R)), diluted with Lipiodol 1:1 thereby excluding the superior left kidney poles from blood flow. During the follow-up period, neither pig presented any clinical symptom correlated to the embolization procedure. Case 1 was sacrificed after 30 days and case 2 after 60 days. Macroscopic and microscopic analysis was performed in both animals. Long-term follow-up of the two cases after endovascular injection of Glubran 2((R)) showed that the embolization procedure was well-tolerated by the swine in terms of clinical symptoms and histological findings. Arterial occlusion was stable and a reasonable quantity of scar tissue appeared between 30 and 60 days, surrounding the ischaemic tissue. This follow-up experimental study offers further evidence that Glubran 2((R)) is a safe embolizing material for human use as far as its chemical activity is concerned.

17.
AJNR Am J Neuroradiol ; 22(9): 1704-10, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11673165

ABSTRACT

BACKGROUND AND PURPOSE: Preoperative assessment of the anatomy and dynamics of cerebral circulation for patients with giant intracranial aneurysm can improve both outcome prediction and therapeutic approach. The aim of our study was to use perfusion MR imaging to evaluate cerebral hemodynamics in such patients before and after extraintracranial high-flow bypass surgery. METHODS: Five patients with a giant aneurysm of the intracranial internal carotid artery underwent MR studies before, 1 week after, and 1 month after high-flow bypass surgery. We performed MR and digital subtraction angiography, and conventional and functional MR sequences (diffusion and perfusion). Surgery consisted of middle cerebral artery (MCA)-internal carotid artery bypass with saphenous vein grafts (n = 4) or MCA-external carotid artery bypass (n = 1). RESULTS: In four patients, MR perfusion study showed impaired hemodynamics in the vascular territory supplied by the MCA of the aneurysm side, characterized by significantly reduced mean cerebral blood flow (CBF), whereas mean transit time (MTT) and regional cerebral blood volume (rCBV) were either preserved, reduced, or increased. After surgery, angiography showed good canalization of the bypass graft. MR perfusion data obtained after surgery showed improved cerebral hemodynamics in all cases, with a return of CBF index (CBFi), MTT, and rCBV to nearly normal values. CONCLUSION: Increased MTT with increased or preserved rCBV can be interpreted as a compensatory vasodilatory response to reduced perfusion pressure, presumably from compression and disturbed flow in the giant aneurysmal sac. When maximal vasodilation has occurred, however, the brain can no longer compensate for diminished perfusion by vasodilation, and rCBV and CBFi diminish. Bypass surgery improves hemodynamics, increasing perfusion pressure and, thus, CBFi. Perfusion MR imaging can be used to evaluate cerebral hemodynamics in patients with intracranial giant aneurysm.


Subject(s)
Cerebral Revascularization , Cerebrovascular Circulation , Intracranial Aneurysm/physiopathology , Intracranial Aneurysm/surgery , Magnetic Resonance Imaging , Adult , Aged , Female , Hemodynamics , Humans , Male , Middle Aged , Time Factors
19.
AJNR Am J Neuroradiol ; 22(2): 255-60, 2001 Feb.
Article in English | MEDLINE | ID: mdl-11156765

ABSTRACT

BACKGROUND AND PURPOSE: The use of MR angiography and contrast-enhanced T1-weighted MR imaging in cases of acute cerebral ischemia may be helpful in the evaluation of middle cerebral artery (MCA) occlusion and leptomeningeal collaterals, respectively. The aim of our work was to investigate the relationship between MCA occlusion, T1-weighted vascular contrast enhancement, hemodynamic alterations, and tissue damage in cases of acute ischemic stroke. METHODS: We studied the MCA territory in 15 patients with acute ischemic stroke within 8 hr of symptom onset. The first MR imaging study (<8 hr after onset) comprised diffusion-weighted imaging, MR angiography, perfusion-weighted imaging, and contrast-enhanced T1-weighted MR imaging sequences. Follow-up MR imaging, performed 1 week later, consisted of MR angiography and T2-weighted fluid-attenuated inversion recovery MR imaging. RESULTS: Early MR angiography showed MCA stem occlusion in nine of 15 patients. Patients with MCA occlusion had significantly larger areas of abnormality on early diffusion-weighted images, significantly larger areas of altered hemodynamics, larger final lesion volumes, and poorer clinical outcome. Among the nine patients with MCA stem occlusion, vascular enhancement was marked in seven and absent in two who had complete MCA infarcts and poor clinical outcome. Among patients with MCA patency, vascular enhancement was marked in only one, mild in four, and absent in one. Patients with marked vascular enhancement had significantly larger regions of altered hemodynamics and significantly higher asymmetries in both regional cerebral blood volume and mean transit time because of increased values in the affected hemisphere. CONCLUSION: Among patients with stroke with MCA occlusion, marked vascular enhancement and increased blood volume indicate efficient leptomeningeal collaterals and compensatory hemodynamic mechanisms.


Subject(s)
Cerebrovascular Circulation , Magnetic Resonance Angiography , Stroke/diagnosis , Stroke/physiopathology , Aged , Aged, 80 and over , Blood Volume , Contrast Media , Female , Hemodynamics , Humans , Image Enhancement , Male , Middle Aged
20.
Neuroradiology ; 42(12): 860-7, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11198202

ABSTRACT

Our aim was to relate MRI findings in patients with severe traumatic brain injury (TBI) to clinical severity and long-term outcome. We studied 37 patients with severe TBI, who were submitted to clinical assessment for disability and cognition and to MRI 60-90 days after trauma. Clinical assessment was also performed 3, 6 and 12 months later. The number and volume of lesions in various cerebral structures were calculated semiautomatically from FLAIR and fast field-echo images. Possible correlations between total and regional lesion volume and clinical deficits were then investigated. The frontal and temporal lobes were most frequently involved. Total lesion volume on FLAIR images correlated significantly with clinical outcome, whereas that on FFE images did not. Regional analysis showed that FLAIR lesion volume in the corpus callosum correlated significantly with scores on disability and cognition scales at the first clinical assessment. FLAIR lesion volume in the frontal lobes correlated significantly with clinical scores 1 year later.


Subject(s)
Brain Injuries/pathology , Cognition Disorders/etiology , Corpus Callosum/pathology , Magnetic Resonance Imaging , Adolescent , Adult , Brain Injuries/rehabilitation , Child , Disabled Persons , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Prognosis , Severity of Illness Index , Temporal Lobe/pathology
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