Developmental instability and phenotypic evolution in a small and isolated bear population.

We explored fluctuating asymmetry (FA) and morphological integration (MI) in the skull of the small, highly inbred and divergent Apennine bear (Ursus arctos marsicanus), to explore its uniqueness and investigate any potential effects of inbreeding depression. We used 3D geometric morphometrics contrasting Apennine bears with other two large outbred bear populations from Scandinavia and Kamchatka as controls. Shape divergence and variability were explored by a principal component analysis on aligned coordinates of 39 landmarks. Procrustes ANOVA, morphological disparity and the global integration index were used to explore FA, shape variance and MI. By remarking Apennine bears as a highly divergent phenotype, we recorded the highest FA and deviation from self-similarity compared with the other two control populations. We conclude that Apennine bears are likely facing developmental instability as a consequence of inbreeding depression, whereas the divergent trait covariance pattern may represent a potential source of evolutionary novelties. We discuss the implications for the conservation and management of this imperiled taxon.

Validation of a visual-aided questionnaire for the self-assessment of hidradenitits suppurativa.

BACKGROUND: Hidradenitis Suppurativa (HS) is a chronic, highly debilitating disease. Few questionnaires have been developed to identify potential HS cases based on simple questions. A visual representation may help in characterising these lesions. OBJECTIVE: To develop and validate a visually assisted questionnaire for HS detection. METHODS: This was an observational diagnostic study on a series of patients with a first diagnosis of HS and a corresponding series of age and gender-matched controls consecutively observed in two Italian centres. The questionnaire was developed based on a critical appraisal of the relevant literature and on expert consensus. Measures of accuracy and reproducibility were assessed. RESULTS: 57 patients with HS and 57 controls were included in the study (mean age 32.9 ± 12.3 years). Based on at least one affirmative answer to the proposed questionnaire items, the accuracy was 95.6%, with a sensitivity of 98.2% and a specificity of 93.0%. Reproducibility was almost perfect on all the tested items (Cohen's kappa ≥ 0.85). LIMITATIONS: The questionnaire was tested only in experimental conditions. CONCLUSION: The questionnaire could be a useful tool for HS screening in the general population. Further studies are needed to confirm its performance in a real-world setting.

[Comparison of various parameters (pitch 1 and 2) in the study of the lung with spiral computerized tomography]. / Confronto tra diversi parametri (pitch 1 e 2) nello studio del polmone con tomografia computerizzata spirale.

INTRODUCTION: In Spiral CT, the pitch is the ratio of the distance the tabletop travels per 360 degrees rotation to nominal slice width, expressed in mm. Performing Spiral CT examinations with pitch 2 allows to reduce examination time, exposure and contrast dose, and X-ray tube overload. We investigated the yield of pitch 2 in lung parenchyma studies, particularly relative to diagnostic image quality. MATERIAL AND METHODS: Thirty patients were submitted to Spiral CT with pitch 1 [10 mm slice thickness, 10 mm/s table feed; 10 mm (a') and 5 mm (a") reconstruction index: protocol A] and with pitch 2 [10 mm slice thickness, 20 mm/s table feed; 10 mm (b') and 5 mm (b") reconstruction index: protocol B]. Five expert radiologists evaluated the images separately and blindly, grading noise, bronchial wall resolution and diagnostic yield on a 0-5 point scale. The results of protocol A versus protocol B images were analyzed statistically using the Mann-Whitney U-test. RESULTS: The mean scores for each parameter ranged 4.13 (.70 standard deviation) for protocol B with 5 mm reconstruction index (b") to 4.81 (.44 standard deviation) for protocol A with 10 mm reconstruction index (a'). These values (max: 5) indicate very positive results on both protocol A and B images. There were no statistically significant interprotocol differences, except for bronchial wall resolution, in favor of protocol A with 5 mm reconstruction index (a") (p = .025), and for diagnostic yield, in favor of protocol A with 10 mm reconstruction index (a') (p = .018). CONCLUSIONS: Spiral CT with pitch 2 is a reliable tool for lung parenchyma studies which permits to reduce examination time and contrast dose, as well as X-ray tube overload and exposure dose.

[Paranasal sinusitis: study with conventional and spiral computerized tomography]. / Flogosi dei seni paranasali: studio mediante Tomografia Computerizzata tradizionale e Tomografia Computerizzata spirale.

This study was aimed at comparing the diagnostic value of conventional computed tomography (CCT) with that of spiral computed tomography (SCT) in sinonasal structures and ostiomeatal complex in thirty patients with inflammatory disease. Ten patients were examined with CCT (3-mm slice thickness, 120 kV, 100 mA, 2-s gantry rotation) and 20 were examined with SCT (3-mm slice thickness, 120 kV, 200 mA, 1-s gantry rotation and computed image reconstruction every 3 mm); table gain was 3 mm (Pitch 1) in 10 patients and 5 mm (Pitch 1.6) in the other 10 patients. With the latter study protocol, diagnostic image quality was the same as with the other two protocols. Moreover, examination time was reduced, with increased patients' comfort; the exposure dose and X-ray tube overload were also reduced, with increased system yield.

[Physics homogenization and the choice of screen-film combination in conventional thoracic radiography]. / L'omogeneizzazione fisica e la scelta della combinazione schermo-pellicola nel radiogramma toracico tradizionale.

The homogenization of conventional chest radiographs is obtained with mechanical filtration of the X-ray beam and it allows opacity compensation of the different anatomical structures under examination; consequently, more pieces of diagnostic information on the mediastinum can be obtained. The authors used a mechanical device for equalization (Tau-Gil, Gilardoni SpA) with five different X-ray film/rare-earth screen combinations (3M Trimax) to investigate the following problems: a) choice of the best film-screen combination; b) results of the dosimetric comparison of filtered and non-filtered examinations; c) qualitative evaluation of equalization in terms of diagnostic information. One thousand analogic chest studies, 500 with and 500 without hard-filtering equalization, were performed with high-tension technique and statistically evaluated with a dedicated program. The authors concluded that: 1) the best qualitative results are obtained with GTU film/T6 screen combination, which seems to make the most satisfying compromise between sensitivity and spatial resolution and allows low X-ray exposure to be combined with good diagnostic results; 2) dosimetric tests clearly show that in hard-filtered studies the average incident dose to the patient is 12% lower than that given with no filter. Particularly, skin and lung doses decrease, while mediastinum dose doubles to allow the simultaneous visualization of mediastinum and parenchyma; 3) a substantial difference exists between the frequencies of excellent, good and bad results in the comparative series (with and without equalization) for the evaluation of central chest areas, especially for mediastinum, retrocardiac region and carena. The overall rate of poor results was reduced by equalization, ranging 11.6% to 2.8% (mean: 6.3%) in equalized studies, and topping 64.2% (average: 35.5%) in non-equalized studies. Therefore, in the authors' experience, equalization with this type of mechanical device improves the depiction of the mediastinal region, with no significant imaging loss in lung parenchyma demonstration. Moreover, hard-filtering decreases average incident dose to the chest and skin-lung dose, increasing mediastinum dose to allow its correct demonstration.

[Nodular lesions simulated on an anthropomorphic thoracic phantom. A comparison between analog and digital images of the thorax]. / Lesioni nodulari simulate su fantoccio antropomorfo toracico. Confronto tra immagini analogiche e digitali del torace.

Aim of this work is to evaluate the diagnostic accuracy of different modalities of digital radiology, compared with conventional radiology, in the detection of lung nodules. Forty images of an anthropomorphic chest phantom, on which simulated nodules had been previously set, were analyzed by 6 radiologists with 4 different viewing modalities: a) conventional radiography; b) photostimulable plates digital radiography; c) photostimulable plates digital image on dedicated monitor; d) conventional radiography digitized with Film Laser Digitizer and viewed on Display Workstation. For each image the radiologists had to transfer on a sketch the site of the detected nodules giving an opinion on their detectability (uncertain-presumable-probable-certain presence) with a 1 to 4 score. The statistical analysis of the results was made using modified ROC curves. No statistically significant difference was found between the areas under a) and c) ROC curves (p = 0.262). A statistically significant difference resulted between the areas under a) and d) ROC curves (p < 0.05) and, particularly, between the a) and b) areas (p < 0.001), in favor of a).

[Conventional radiology, digital radiology with photostimulable phosphor, laser digitalization of thoracic radiographic films at the bedside. A comparative study]. / Radiologia tradizionale, radiologia digitale con fosfori fotostimolabili, digitalizzazione laser delle pellicole radiografiche negli esami toracici dei pazienti a letto. Studio comparativo.

The bedside chest images obtained with conventional radiology and with "on line" and "off line" digital modalities were compared to evaluate the respective capabilities in visualizing chest anatomical structures. Seventy patients were submitted to bedside chest examinations with a portable unit; both a conventional film and a digital system (PCR Graphics 1, Philips) with photostimulable phosphor imaging plate were fitted in the radiographic cassette. The former was digitized using an "off line" laser beam unit (FD 2000, Dupont); the latter was subsequently postprocessed by modifying contrast, optical density and spatial frequencies. Thus, 4 different viewing modalities were obtained for each examination: a) conventional radiography; b) standard digital radiography; c) postprocessed digital radiography; d) digitized conventional radiography. Detectability rates of chest anatomical structures were analyzed by 4 independent radiologists on the different images and expressed by a score 1-4. The values were always higher with digital modalities than with the conventional one and the differences were statistically significant (Student's t-test modified by Bonferroni). In particular, the greatest difference was found between c) and a) in retrocardiac lung parenchyma and in skeletal structures, in favour of c). Concerning the comparative adequacy of the various digital modalities, higher detectability rates of chest anatomical structures were obtained with c), but also with b), than with d).

[Digital radiology with photostimulable image plates and conventional radiology in the study of the interstitial pathology of the lung]. / La radiologia digitale a piastre fotostimolabili e la radiologia tradizionale nello studio della patologia interstiziale del polmone.

To evaluate the diagnostic possibilities of Digital Radiography (DR) and of Conventional Radiography (CR) in the diagnosis of fine chest lesions, 100 patients with AIDS were examined with both techniques. The gold standards were 67Ga scintigraphy and bronchial washing in 100 patients and Computed Tomography (CT) in 50 patients. The data obtained from DR and CR examinations were separately evaluated by 4 readers and subsequently analyzed by ROC curves with Standard Error calculation and by comparing the areas below the characteristic curves with Student's paired t-test (p less than or equal to 0.05). Statistical analysis showed DR and CR to be of equivalent diagnostic value in the study of interstitial lung diseases.

[Interstitial radiotherapy using I-125 seeds in brain neoplasms of slow development]. / Radioterapia interstiziale con semi di 125I nelle neoplasie cerebrali a lenta evoluzione.

The opportunity of stereotactic biopsy for the histological diagnosis of brain tumors, the radiobiologic bases, clinical implications and technical possibilities of interstitial radiation therapy are discussed. The results of 9 cases, out of 14 treated to-date over 20 months, with a minimum follow-up of 4 months, are presented.

[Use of radioisotopes in the evaluation of coronary disease]. / Uso dei radioisotopi nella valutazione della cardiopatia coronarica.

A study on myocardial perfusion through scintigraphy with 201-Tl has been carried on in a group of 57 persons: among them 45 had myocardial infarction and 12 had myocardial ischemia in act. In consideration of this experience, the myocardial scintigraphy with 201-Tl seems to be a valid investigation method to support the electro-vectocardiography when evaluating, bloodlessly, ischemical cardiopathies. In general, the correlation between electro-vectorcardiographic and scintigraphic data has been satisfactory. Referring to stroken parts, we can say that also those cardiac sectors usually very difficult to be explored with other radio elements such as 131-CS and 42-K, have been adequately studied with 201-Tl. To sum up, we can say that scintigraphic investigation of myocardium with 201-Tl is certainly a valid blood-less method to diagnose ischemical cardiopathy with the advantage to be also a useful diagnostical element for the evaluation of the microcirculation.

133Xe regional lung perfusion and ventilation study with the computer-assisted gamma-camera.

A new method of studying regional lung functions using 133Xe and the computer-assisted scintillation camera is described. The method and the computer processing give details of the distribution of 133Xe during perfusion and ventilation and also measures of lung function. Some cases are described in detail, and the clinical significance of the method was confirmed in 45 cases.

Deadtime correcton in high count rate quantitative dynamic studies with computer-assisted Anger-cameras.

The use of tracers with high radioactivity in rapid dynamic quantitative studies (such as radioisotope angiocardiography), performed by the Anger-camera and data-processor, makes it possible to obtain a high counting ratemfor correct interpretation of the results of the analysis of activity/time curves in regions of interest, the authors determined, under different working conditions, the deadtimes of two Anger-cameras (Pho-gamma HP and Radicamera II), both connected to a data-processing system (Med-II). The problems inherent in this determination are analyzed and discussed. A computer program for curve correction was written and some examples of applications of it are presented, including an experiment to test the accuracy of the correction.

Diagnostic value of computer-assisted quantitative radioisotope angiocardiography.

The cardiac cavities and large vessels were studied by radioisotope angiocardiography with 99mTc-labelled albumin, using a gamma-camera linked to Med-II, with subsequent digital scanning and analysis by coloured video unit (VDP2) of the areas of iso-activity. The results are illustrated of 8 cases selected from the aggregate case histories of 78 patients (1 normal, 4 congenital heart disease, 2 rheumatic, 1 cor pulmonale chronicum). The direct observation of the course of the bolus and the activity/time curves in areas of interest in the cardiac cavities and the lungs, together with the representation of the areas of iso-activity, were useful for diagnosis and physiopathological evaluation of the heart conditions in the patients.