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Monda E, De Michele G, Diana G, Verrillo F, Rubino M, Cirillo A, Fusco A, Amodio F, Caiazza M, Dongiglio F, Palmiero G, Buono P, Russo MG, Limongelli G. Left Ventricular Non-Compaction in Children: Aetiology and Diagnostic Criteria. Diagnostics (Basel) 2024; 14:115. [PMID: 38201424 PMCID: PMC10871098 DOI: 10.3390/diagnostics14010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Left ventricular non-compaction (LVNC) is a heterogeneous myocardial disorder characterized by prominent trabeculae protruding into the left ventricular lumen and deep intertrabecular recesses. LVNC can manifest in isolation or alongside other heart muscle diseases. Its occurrence among children is rising due to advancements in imaging techniques. The origins of LVNC are diverse, involving both genetic and acquired forms. The clinical manifestation varies greatly, with some cases presenting no symptoms, while others typically manifesting with heart failure, systemic embolism, and arrhythmias. Diagnosis mainly relies on assessing heart structure using imaging tools like echocardiography and cardiac magnetic resonance. However, the absence of a universally agreed-upon standard and limitations in diagnostic criteria have led to ongoing debates in the scientific community regarding the most reliable methods. Further research is crucial to enhance the diagnosis of LVNC, particularly in early life stages.
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Affiliation(s)
- Emanuele Monda
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
- Institute of Cardiovascular Science, University College London, London WC1N 3JH, UK
| | - Gianantonio De Michele
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Gaetano Diana
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Federica Verrillo
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Marta Rubino
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Annapaola Cirillo
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Adelaide Fusco
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Federica Amodio
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Martina Caiazza
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Francesca Dongiglio
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Giuseppe Palmiero
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Pietro Buono
- Department of Maternal and Child Health, General Directorate for Health, 80131 Naples, Italy
| | - Maria Giovanna Russo
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Giuseppe Limongelli
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
- Institute of Cardiovascular Science, University College London, London WC1N 3JH, UK
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Iavarone M, Monda E, Vritz O, Albert DC, Rubino M, Verrillo F, Caiazza M, Lioncino M, Amodio F, Guarnaccia N, Gragnano F, Lombardi R, Esposito G, Bossone E, Calabrò P, Losi MA, Limongelli G. Medical treatment of patients with hypertrophic cardiomyopathy: An overview of current and emerging therapy. Arch Cardiovasc Dis 2022; 115:529-537. [DOI: 10.1016/j.acvd.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/02/2022]
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Monda E, Lioncino M, Rubino M, Caiazza M, Cirillo A, Fusco A, Pacileo R, Fimiani F, Amodio F, Borrelli N, Colonna D, D'Onofrio B, Frisso G, Drago F, Castelletti S, Sarubbi B, Calabrò P, Russo MG, Limongelli G. The Risk of Sudden Unexpected Cardiac Death in Children: Epidemiology, Clinical Causes, and Prevention. Heart Fail Clin 2021; 18:115-123. [PMID: 34776073 DOI: 10.1016/j.hfc.2021.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
"Sudden unexplained death (SUD) is a tragic event for both the family and community, particularly when it occurs in young individuals. Sudden cardiac death (SCD) represents the leading form of SUD and is defined as an unexpected event without an obvious extracardiac cause, occurring within 1 hour after the onset of symptoms. In children, the main causes of SCD are inherited cardiac disorders, whereas coronary artery diseases (congenital or acquired), congenital heart diseases, and myocarditis are rare. The present review examines the current state of knowledge regarding SCD in children, discussing the epidemiology, clinical causes, and prevention strategies."
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Affiliation(s)
- Emanuele Monda
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Michele Lioncino
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Marta Rubino
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Martina Caiazza
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Annapaola Cirillo
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Adelaide Fusco
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Roberta Pacileo
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Fabio Fimiani
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Federica Amodio
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Nunzia Borrelli
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Diego Colonna
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Barbara D'Onofrio
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Giulia Frisso
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Fabrizio Drago
- Istituto Auxologico Italiano, IRCCS-Center for Cardiac Arrhythmias of Genetic Origin, Via Pier Lombardo 22, 20135 Milan, Italy
| | - Silvia Castelletti
- Istituto Auxologico Italiano, IRCCS-Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy
| | - Berardo Sarubbi
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Paolo Calabrò
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Maria Giovanna Russo
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Giuseppe Limongelli
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy; Institute of Cardiovascular Sciences, University College of London and St. Bartholomew's Hospital, Grower Street, London WC1E 6DD, UK.
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Monda E, Lioncino M, Rubino M, Passantino S, Verrillo F, Caiazza M, Cirillo A, Fusco A, Di Fraia F, Fimiani F, Amodio F, Borrelli N, Mauriello A, Natale F, Scarano G, Girolami F, Favilli S, Limongelli G. Diagnosis and Management of Cardiovascular Involvement in Friedreich Ataxia. Heart Fail Clin 2021; 18:31-37. [PMID: 34776081 DOI: 10.1016/j.hfc.2021.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Friedreich ataxia (FRDA) is an autosomal recessive neurodegenerative disorder caused by a homozygous GAA triplet repeat expansion in the frataxin gene. Cardiac involvement, usually manifesting as hypertrophic cardiomyopathy, can range from asymptomatic cases to severe cardiomyopathy with progressive deterioration of the left ventricular ejection fraction and chronic heart failure. The management of cardiac involvement is directed to prevent disease progression and cardiovascular complications. However, direct-disease therapies are not currently available for FRDA. The present review aims to describe the current state of knowledge regarding cardiovascular involvement of FRDA, focusing on clinical-instrumental features and management of cardiac manifestation.
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Affiliation(s)
- Emanuele Monda
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Michele Lioncino
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Marta Rubino
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Silvia Passantino
- Department of Pediatric Cardiology, Meyer Children's Hospital, Viale Gaetano Pieraccini, 24, 50139 Florence, Italy
| | - Federica Verrillo
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Martina Caiazza
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Annapaola Cirillo
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Adelaide Fusco
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Francesco Di Fraia
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Fabio Fimiani
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Federica Amodio
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Nunzia Borrelli
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Alfredo Mauriello
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Francesco Natale
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Gioacchino Scarano
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy
| | - Francesca Girolami
- Department of Pediatric Cardiology, Meyer Children's Hospital, Viale Gaetano Pieraccini, 24, 50139 Florence, Italy
| | - Silvia Favilli
- Department of Pediatric Cardiology, Meyer Children's Hospital, Viale Gaetano Pieraccini, 24, 50139 Florence, Italy
| | - Giuseppe Limongelli
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via L. Bianchi, 80131 Naples, Italy; Institute of Cardiovascular Sciences, University College of London and St. Bartholomew's Hospital, Grower Street, London WC1E 6DD, UK.
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Scudiero O, Lombardo B, Brancaccio M, Mennitti C, Cesaro A, Fimiani F, Gentile L, Moscarella E, Amodio F, Ranieri A, Gragnano F, Laneri S, Mazzaccara C, Di Micco P, Caiazza M, D’Alicandro G, Limongelli G, Calabrò P, Pero R, Frisso G. Exercise, Immune System, Nutrition, Respiratory and Cardiovascular Diseases during COVID-19: A Complex Combination. Int J Environ Res Public Health 2021; 18:904. [PMID: 33494244 PMCID: PMC7908487 DOI: 10.3390/ijerph18030904] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/07/2021] [Accepted: 01/19/2021] [Indexed: 12/15/2022]
Abstract
Coronaviruses (CoVs) represent a large family of RNA viruses that can infect different living species, posing a global threat to human health. CoVs can evade the immune response, replicate within the host, and cause a rapid immune compromise culminating in severe acute respiratory syndrome. In humans, the immune system functions are influenced by physical activity, nutrition, and the absence of respiratory or cardiovascular diseases. This review provides an in-depth study between the interactions of the immune system and coronaviruses in the host to defend against CoVs disease.
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Affiliation(s)
- Olga Scudiero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (O.S.); (B.L.); (C.M.); (C.M.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy; (L.G.); (A.R.)
| | - Barbara Lombardo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (O.S.); (B.L.); (C.M.); (C.M.)
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy; (L.G.); (A.R.)
| | - Mariarita Brancaccio
- Department of Biology and Evolution of Marine Organisms, Stazione Zoologica Anton Dohrn, 80121 Naples, Italy;
| | - Cristina Mennitti
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (O.S.); (B.L.); (C.M.); (C.M.)
| | - Arturo Cesaro
- Department of Translational Medical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy; (A.C.); (E.M.); (F.A.); (F.G.)
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
| | - Fabio Fimiani
- Unit of Inherited and Rare Cardiovascular Diseases, Azienda Ospedaliera di Rilievo Nazionale AORN Dei Colli, “V.Monaldi”, 80122 Naples, Italy;
| | - Luca Gentile
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy; (L.G.); (A.R.)
| | - Elisabetta Moscarella
- Department of Translational Medical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy; (A.C.); (E.M.); (F.A.); (F.G.)
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
| | - Federica Amodio
- Department of Translational Medical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy; (A.C.); (E.M.); (F.A.); (F.G.)
| | - Annaluisa Ranieri
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy; (L.G.); (A.R.)
| | - Felice Gragnano
- Department of Translational Medical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy; (A.C.); (E.M.); (F.A.); (F.G.)
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
| | - Sonia Laneri
- Department of Pharmacy, University of Naples Federico II Via Montesano, 80131 Naples, Italy;
| | - Cristina Mazzaccara
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (O.S.); (B.L.); (C.M.); (C.M.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Pierpaolo Di Micco
- Department of Internal Medicine and Emergency Room, Ospedale Buon Consiglio Fatebenefratelli, 80123 Naples, Italy;
| | - Martina Caiazza
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 81100 Naples, Italy;
| | - Giovanni D’Alicandro
- Department of Neuroscience and Rehabilitation, Center of Sports Medicine and Disability, AORN, Santobono-Pausillipon, 80122 Naples, Italy;
| | - Giuseppe Limongelli
- Department of Cardio-Thoracic and Respiratory Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy;
| | - Paolo Calabrò
- Department of Translational Medical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy; (A.C.); (E.M.); (F.A.); (F.G.)
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
| | - Raffaela Pero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (O.S.); (B.L.); (C.M.); (C.M.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Giulia Frisso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (O.S.); (B.L.); (C.M.); (C.M.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
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Addeo M, Buonaiuto S, Guerriero I, Amendola E, Visconte F, Marino A, De Angelis MT, Russo F, Roberto L, Marotta P, Russo NA, Iervolino A, Amodio F, De Felice M, Lucci V, Falco G. Insight into Nephrocan Function in Mouse Endoderm Patterning. Int J Mol Sci 2019; 21:ijms21010008. [PMID: 31861348 PMCID: PMC6981620 DOI: 10.3390/ijms21010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/09/2019] [Accepted: 12/16/2019] [Indexed: 01/16/2023] Open
Abstract
Endoderm-derived organs as liver and pancreas are potential targets for regenerative therapies, and thus, there is great interest in understanding the pathways that regulate the induction and specification of this germ layer. Currently, the knowledge of molecular mechanisms that guide the in vivo endoderm specification is restricted by the lack of early endoderm specific markers. Nephrocan (Nepn) is a gene whose expression characterizes the early stages of murine endoderm specification (E7.5–11.5) and encodes a secreted N-glycosylated protein. In the present study, we report the identification of a new transcript variant that is generated through alternative splicing. The new variant was found to have differential and tissue specific expression in the adult mouse. In order to better understand Nepn role during endoderm specification, we generated Nepn knock-out (KO) mice. Nepn−/− mice were born at Mendelian ratios and displayed no evident phenotype compared to WT mice. In addition, we produced nullizygous mouse embryonic stem cell (mESC) line lacking Nepn by applying (CRISPR)/CRISPR-associated systems 9 (Cas9) and employed a differentiation protocol toward endoderm lineage. Our in vitro results revealed that Nepn loss affects the endoderm differentiation impairing the expression of posterior foregut-associated markers.
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Affiliation(s)
- Martina Addeo
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
- Dipartimento di Biologia, Università degli Studi di Napoli “Federico II”, 80126 Napoli, Italy; (S.B.); (A.M.); (E.A.)
| | - Silvia Buonaiuto
- Dipartimento di Biologia, Università degli Studi di Napoli “Federico II”, 80126 Napoli, Italy; (S.B.); (A.M.); (E.A.)
| | - Ilaria Guerriero
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
| | - Elena Amendola
- Dipartimento di Biologia, Università degli Studi di Napoli “Federico II”, 80126 Napoli, Italy; (S.B.); (A.M.); (E.A.)
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore”, CNR, 80131 Napoli, Italy;
| | | | - Antonio Marino
- Dipartimento di Biologia, Università degli Studi di Napoli “Federico II”, 80126 Napoli, Italy; (S.B.); (A.M.); (E.A.)
| | - Maria Teresa De Angelis
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
| | - Filomena Russo
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
| | - Luca Roberto
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
| | - Pina Marotta
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
| | - Nicola Antonino Russo
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
| | - Anna Iervolino
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
| | - Federica Amodio
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
| | - Mario De Felice
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore”, CNR, 80131 Napoli, Italy;
| | - Valeria Lucci
- Dipartimento di Biologia, Università degli Studi di Napoli “Federico II”, 80126 Napoli, Italy; (S.B.); (A.M.); (E.A.)
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore”, CNR, 80131 Napoli, Italy;
- Correspondence: (V.L.); (G.F.); Tel.: +39-081-679083 (V.L.); +39-081-679092 (G.F.)
| | - Geppino Falco
- Istituto di Ricerche Genetiche “G. Salvatore”, Biogem s.c.ar.l, Ariano Irpino, 83031 Avellino, Italy; (M.A.); (I.G.); (M.T.D.A.); (F.R.); (L.R.); (N.A.R.); (P.M.); (F.A.); (A.I.)
- Dipartimento di Biologia, Università degli Studi di Napoli “Federico II”, 80126 Napoli, Italy; (S.B.); (A.M.); (E.A.)
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore”, CNR, 80131 Napoli, Italy;
- Correspondence: (V.L.); (G.F.); Tel.: +39-081-679083 (V.L.); +39-081-679092 (G.F.)
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Borzelli A, Amodio F, Paladini A, de Magistris G, Giurazza F, Silvestre M, Corvino F, Corvino A, Frauenfelder G, Pane F, Coppola M, Zobel DB, Paladini L, Amodeo E, Cavaglià E, Niola R. Successful endovascular treatment of a recurrent giant celiac artery aneurysm. Radiol Case Rep 2019; 14:723-728. [PMID: 30988864 PMCID: PMC6447743 DOI: 10.1016/j.radcr.2019.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 03/19/2019] [Accepted: 03/24/2019] [Indexed: 12/05/2022] Open
Abstract
Visceral artery aneurysms are very rare and aneurysms of the celiac trunk are the rarest ones: they are in most cases asymptomatic and their detection is frequently incidental. In this article we report the case of a man affected by severe abdominal pain with a huge aneurysm of the celiac trunk, first successfully treated with coil embolization, but, after 10 months, another endovascular embolization was required for deployment of the metallic coils previously released, ahead into the fund of the sac with recanalization of the aneurysm. A second endovascular treatment was performed with other coils and Amplatzer-Plug. The high risk of rupture makes treatment of such aneurysms mandatory and surgery is still considered the gold standard therapy of VAA, but, due to its high morbidity and mortality risks, in the last years, it has been widely replaced by endovascular embolization. An effective endovascular embolization requires not only the complete filling of the aneurysmal sac, but also the complete vascular exclusion of its in-flow and out-flow tracts, to reduce the risk of its anterograde or retrograde reperfusion.
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Affiliation(s)
- A. Borzelli
- Department of Interventional Radiology, AORN ``A. Cardarelli'', Via A. Cardarelli 9, 80131 Naples, Italy
- Corresponding author.
| | - F. Amodio
- Department of Interventional Radiology, AORN ``A. Cardarelli'', Via A. Cardarelli 9, 80131 Naples, Italy
| | - A. Paladini
- Department of Services Diagnosis and Therapies, Radiology Institute, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso G. Mazzini 18, 28100 Novara, Italy
| | - G. de Magistris
- Department of Interventional Radiology, AORN ``A. Cardarelli'', Via A. Cardarelli 9, 80131 Naples, Italy
| | - F. Giurazza
- Department of Interventional Radiology, AORN ``A. Cardarelli'', Via A. Cardarelli 9, 80131 Naples, Italy
| | - M. Silvestre
- Department of Interventional Radiology, AORN ``A. Cardarelli'', Via A. Cardarelli 9, 80131 Naples, Italy
| | - F. Corvino
- Department of Interventional Radiology, AORN ``A. Cardarelli'', Via A. Cardarelli 9, 80131 Naples, Italy
| | - A. Corvino
- Dipartimento di scienze biomediche avanzate, Università degli studi di Napoli “Federico II”, Via S.Pansini, 80131 Naples, Italy
| | - G. Frauenfelder
- Department of Radiology, Campus Bio-medico University, Via Alvaro del Portillo, 200, 00100 Rome, Italy
| | - F. Pane
- Dipartimento di scienze biomediche avanzate, Università degli studi di Napoli “Federico II”, Via S.Pansini, 80131 Naples, Italy
| | - M. Coppola
- Dipartimento di scienze biomediche avanzate, Università degli studi di Napoli “Federico II”, Via S.Pansini, 80131 Naples, Italy
| | - D. Beomonte Zobel
- Division of Interventional Radiology, IFO Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy
| | - L. Paladini
- Università Cattolica del Sacro Cuore, Rome- Fondazione Gemelli, Rome, Italy
| | - E.M. Amodeo
- Università Cattolica del Sacro Cuore, Rome- Fondazione Gemelli, Rome, Italy
| | - E. Cavaglià
- Department of Interventional Radiology, AORN ``A. Cardarelli'', Via A. Cardarelli 9, 80131 Naples, Italy
| | - R. Niola
- Department of Interventional Radiology, AORN ``A. Cardarelli'', Via A. Cardarelli 9, 80131 Naples, Italy
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Amodio F, Esposito F, Noviello D, Giugliano M, Valentino ML. Double blind ureteral duplication: report of an unusual case. Radiol Med 2002; 103:543-6. [PMID: 12207192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- F Amodio
- Azienda Ospedaliera di Rilievo Nazionale Santobono, Pausilipon, U. O. di Radiologia
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9
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Amodio F, Di Martino S, Esposito S, Iorio S, Hierholzer J, Rea G, Bizzarro A, Vallone G. [Role of flowmetric analysis and of color-Doppler ultrasonography with contrast media in the different phases and follow-up of Graves' disease]. Radiol Med 2001; 102:233-7. [PMID: 11740450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
PURPOSE The objectives of this study were: 1) to evaluate the role of color-Doppler ultrasonography (CDU) assessment of thyroid vascularity, measuring the peak systolic velocity (PSV) at the level of the inferior thyroid artery, and the intrathyroid vascularization in Graves' diseas; 2) to evaluate the role of contrast agent administration in predicting the relapse of hyperthyroidism or the biological activity of the disease after withdrawal of antithyroid drugs. PATIENTS AND METHOD The study included 74 Graves' patients (59 F/ 15 M; mean age 45 years; range 23-71). Graves' disease was diagnosed according to the usual clinical and laboratory criteria. On the basis of the clinical and biochemical findings we divided Graves' patients into 4 different groups. Treatment was continued for at least 12 months, CDU examination was carried out after discontinuing therapy. Eight patients showed a relapse of hyperthyroidism within 5 months after suspension of therapy. In all cases the evaluation of intraparenchymal vascularization and PSV at the level of the inferior thyroid artery in basal conditions was followed by administration of contrast agent (Levovist, 300 mg/ml), with slow infusion (<2 ml/min) to avoid blooming artifact. Intraparenchymal vascularization was classified into 4 patterns according to Vitti et al. RESULTS The value of the peak systolic velocity (PSV) at the level of the inferior thyroid artery was the best predictor of relapse. A value higher than 40 cm/sec was present in all the patients that showed relapse and only in two patients with stable remission. Administration of contrast agent is important to evaluate the biological activity of the disease. In the 5 patients exhibiting slightly increased vascularization after contrast agent administration we could assume the clinico-pathological recovery. CONCLUSIONS CDU study of thyroid vascularization, based on the measurement of PSV at the level of the inferior thyroid artery and on the response to contrast agent administration is useful to distinguish three groups of patients: A) PSV >40 cm/sec with pattern III for at least 10 minutes from the beginning of the contrast agent administration (High risk of relapse); B) PSV <40 cm/sec with pattern II or III after contrast agent administration (Biological activity of the disease-Thyroiditis); C) PSV <40 cm/sec with Pattern I after contrast agent administration (Poor biological activity of the disease-recovery).
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Affiliation(s)
- F Amodio
- Dipartimento di Scienze Biomorfologiche e Funzionali, Istituto di Scienze Radiologiche, Università degli Studi Federico II, Naples, Italy
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Amodio F, Hierholzer J, Mansueto G, Lemke A, Smaltino F. Quiz case of the month. Latero-ventral hernia of the abdominal wall (Spigelian hernia). Eur Radiol 2001; 10:1839-40. [PMID: 11097420 DOI: 10.1007/pl00021060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- F Amodio
- Department of Radiology, Università Federico II, Napoli, Italy
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Rea G, Mecca ML, Amodio F, Mansueto G, Vallone G. [Renal adenocarcinoma in childhood. A case report]. Radiol Med 2000; 100:385-6. [PMID: 11213422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- G Rea
- Dipartimento di Scienze Biomorfologiche e Funzionali, Servizio di Radiologia, Napoli
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Mansueto G, Somma P, Amodio F, Pascale A, Meccariello R, Gatta G, Carbone M, Di Prisco B. [Mesothelial cyst of the diaphragm. Presentation of an unusual case]. MINERVA CHIR 2000; 55:565-7. [PMID: 11140114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The authors report a case of mesothelial cyst of the diaphragm in a boy 11 years old who was examined for pain in the right hypochondrium with exacerbation during respiratory movements. Ultrasonography and CT suggested the diagnosis. However the final diagnosis of mesothelial cyst of the diaphragm was possible only after laparotomy and histological examination. The topographical, clinical, radiological, therapeutic and histological aspects of primary cysts of the diaphragm are presented and a survey of the literature is made.
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Affiliation(s)
- G Mansueto
- Sezione di Anatomia Patologica e Citopatologia, Dipartimento di Scienze Biomorfologiche e Funzionali, Università degli Studi Federico II, Napoli.
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Tamasi S, Rossi E, Carbone M, Amodio F, Mattace Raso M, Brunese L, Ciccarelli R, Vallone G. [Echographic evaluation of the thymus gland in childhood]. Radiol Med 2000; 99:352-4. [PMID: 10938704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
INTRODUCTION The thymus is a linphoepithelial organ located mostly in the anterior mediastinum and, for a smaller part, in the neck. The gland is particularly developed in the fetus and in children, while it shrinks in young adults following an involution process. We investigated the US appearance of the thymus in normal pediatric subjects to gather information for use in pediatric patients with suspected thymus conditions, using a safe, irradiation-free, technique. MATERIAL AND METHODS We performed a US examination of the anterior mediastinum and the neck in 30 children (14 males and 16 females) ranging in age 6 months to 11 years. We used a Sonora LOGIC 700 MD General Electrics unit with 7.5-13 MHz linear probes and acquired transverse and longitudinal scans on the chest wall and the neck, integrated with intercostal scans. RESULTS The thymus had the same echogenicity as the liver parenchyma in 22 children (73.3%), lower echogenicity in 2 (6.6%, age range 6-12 months) and higher echogenicity with heterogeneous structure in 6 children (20%, age range 8-11 years). The gland was in central and symmetric localization in 20 children (66.6%) while it exhibited a slight deviation leftwards in 7 (23.3%) and rightwards in 3 children (10%). We considered as normal the following values: in the right lobe, 1.4 cm for the AP diameter and 2.5 cm for the longitudinal one; in the left lobe, 1.4 cm for the AP diameter and 2.9 cm for the longitudinal one. DISCUSSION AND CONCLUSION Radiological studies of the thymus are really difficult to perform because the gland is extremely variable in size, extension and shape. The thymus has the same echogenicity as the liver parenchyma and lower echogenicity than the thyroid parenchyma. We believe that US is an effective technique for studying the thymus in all its involution stages and that provides similar information to CT and MRI. Also, US does not use radiations and needs no sedation, which improves safety for young patients.
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Affiliation(s)
- S Tamasi
- Dipartimento di Scienze Biomorfologiche e Funzionali, Università degli Studi Federico II, Napoli
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Abstract
We report a case of decompression illness in which the patient developed paraparesis during scuba diving after rapid ascent. MRI of the spine revealed a focal intramedullary lesion consistent with the symptoms. The pathophysiological and radiological aspects of spinal decompression illness are discussed.
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Affiliation(s)
- J Hierholzer
- Department of Radiology, Charité Campus Virchow-Klinikum, Humboldt Universität, Berlin, Germany.
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Amodio F, Rossi E, Carbone M, Brunese L, Tamasi S, Mansueto G, Somma P, Vallone G. [Echographic study with high-frequency and high-spatial resolution transducer in the evaluation of renal transplant in pediatric age]. Radiol Med 2000; 99:68-71. [PMID: 10803190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
PURPOSE We investigated the role of power Doppler US with a high-frequency and high-resolution transducer (13 MHz) in the visualization of interlobular arterioles in patients with normally functioning renal transplants or with chronic rejection. MATERIAL AND METHODS We examined 15 patients (mean age 15 years; range 10-18 years) with a General Electric 500 MD unit using 7.5 and 13 MHz linear transducers. In all the patients serum creatinine and diuresis were evaluated; 4 patients underwent US-guided biopsy that resulted in the diagnosis of chronic rejection. RESULTS Normally functioning renal transplants were found in 11 patients and chronic rejection was seen in 4. In normally functioning renal transplants, interlobular vessels could be depicted as "cortical blush" with the 7.5 MHz transducer; in the same patients power Doppler US with the 13 MHz transducer permitted a correct evaluation of interlobular vessels that were arranged in series like a palisade. In chronic rejection power Doppler US with the 13 MHz transducer better depicted cortical vascularity and showed irregular, narrow arteries. CONCLUSION Power Doppler US with a 13 MHz transducer is particularly useful in children after renal transplants due to their reduced tissutal thickness. The lateral resolution of 13 MHz transducers (< 0.3 mm) allows to separate interlobular vessels from each other and the high frequency of the probe can depict interlobular vessels in the peripheral cortex. The optimal visualization of cortical vascularity with a 13 MHz transducer allows early detection of chronic rejection.
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Affiliation(s)
- F Amodio
- Dipartimento di Scienze Biomorfologiche e Funzionali, Università degli Studi Federico II, Napoli, NA
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Salzano A, Rossi E, De Rosa A, Carbone M, Amodio F, Muto M, Accattatis V, Brunese L. [The role of computed tomography in assessing subphrenic abscesses after posttraumatic splenectomy]. Radiol Med 1999; 98:173-7. [PMID: 10575448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
INTRODUCTION We studied subphrenic inflammatory abscesses and splenic fluid collections after splenectomy for trauma. These complications may appear early or late postoperatively; they are easily demonstrated with CT, which permits accurate spatial assessment of the lesions and appropriate treatment with percutaneous drainage. We investigated the diagnostic accuracy of CT in subphrenic inflammatory conditions after emergency splenectomy for traumatic spleen rupture and found that CT is a precious tool for rapid and easy diagnosis and follow-up of subphrenic abscesses treated with percutaneous drainage. MATERIAL AND METHODS Thirteen patients with left subphrenic inflammatory abscesses after splenectomy for trauma were examined from 1994 to 1998. They were 9 men and 4 women ranging in age 16-67 years (mean: 32). CT demonstrated abscesses early postoperatively in 9 patients and late postoperatively (mean: 3 months) in 4 patients. Abscesses were diagnosed with CT on admission for an abdominal emergency in 3 cases; one abscess was found at outpatient US performed for persisting left abdominal pain. CT-guided percutaneous drainage was performed in all patients with the Trocar technique. RESULTS A large inflammatory liquid collection with the typical "liquid pseudospleen" appearance and characterized by tomodensitometric coefficients of corpusculated fluid was seen in 3 cases. Multiple confluent lesions with septa were found in 3 cases. Contrastography of the abscess cavity with the injection of a water-soluble iodinated contrast agent was performed in 2 cases to detect fistulas connecting to the intestinal loops. Subphrenic abscesses had the same CT patterns both early and late postoperatively, with the collection organizing into thick and corpusculated phlogistic material and exhibiting enhanced capsulofibrous differentiation. Air bubbles and water-air levels within the collection were found in 7 cases and considered a pathognomonic sign of inflammatory abscesses. A periabscessual reaction involving intestinal loops and adjacent organs was seen in 4 cases. DISCUSSION AND CONCLUSIONS Splenectomy causes depressed phagocytosis and decreases serum levels of IgM and antigen response. This calls for careful selection of the patients absolutely requiring splenectomy, such as those with decompensated circulation and multiple parenchymal ruptures or spleen detachment from its stalk. Subphrenic abscesses after splenectomy account for 2.5% of postoperative complications and those after splenectomy for trauma are rarer still, with 1.3%. CT is the imaging method of choice in detecting inflammatory abscesses in the residual splenic cavity and assessing their extent. CT-guided drainage is the first-line treatment, while surgery is reserved to later stages, when drainage fails or other complications occur. Finally, CT permits accurate positioning of the catheter inserted with the Trocar technique and its immediate monitoring, which permits to assess treatment efficacy.
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Affiliation(s)
- A Salzano
- Servizio di Radiologia, Ospedale Loreto-Mare, Napoli
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Amodio F, Carbone M, Rossi E, Brunese L, Pisano G, Iorio S, Benincasa G, Vallone G. [An update of B-mode echography in the characterization of nodular thyroid diseases. An echographic study comparing 7.5 and 13 MHz probes]. Radiol Med 1999; 98:178-82. [PMID: 10575449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE We investigated B-mode US capabilities in diagnosis and characterizing thyroid nodules and compared our personal findings with those of the few analytical studies in the literature. We also compared the diagnostic accuracy of conventional 7.5 MHz versus more recent 13 MHz transducers. MATERIAL AND METHODS We examined 136 consecutive patients with a single thyroid nodule: they were 97 women and 39 men, age ranging 15-87 years (mean: 37.4). The patients were submitted to scintigraphy and laboratory tests first and then to US, fine-needle biopsy and/or histologic examination. The final diagnosis was made at cytology and/or histology: we had 98 follicular hyperplasias, 20 follicular adenomas and 18 carcinomas. We studied the presence/absence of the halo sign, cystic portions, microcalcifications; nodule margins and echogenicity relative to the thyroid gland were also studied. RESULTS The presence of microcalcifications had the highest specificity for malignancy. The sensitivity of this parameter was higher with 13 MHz than with 7.5 MHz transducers. Relative to microcalcifications, absence of cystic portions and irregular margins, 13 MHz US had 64.7-89% accuracy. The halo sign and lesion echogenicity did not permit a reliable differential diagnosis between benign and malignant nodules with both 7.5 and 13 MHz transducers. The association of microcalcifications and irregular margins had the highest accuracy, scoring 86% at 7.5 MHz and 90.5% at 13 MHz. CONCLUSIONS High frequency US is a sensitive tool for diagnosing thyroid nodes. Accurate analysis of the US signs can suggest the benign/malignant lesion nature, which must be integrated with color, power and pulsed Doppler findings.
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Affiliation(s)
- F Amodio
- Dipartimento di Scienze Biomorfologiche e Funzionali, Istituto di Scienze Radiologiche, II Università, Napoli
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Salzano A, Carbone M, Rossi E, De Rosa A, Muto M, Amodio F, Rea G, Ginolfi F. [Defecography and treatment of essential anal pain]. Radiol Med 1999; 98:48-52. [PMID: 10566296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
INTRODUCTION Proctalgia is a chronic anal pain in the absence of any organic conditions of the anorectum and excluding such morphofunctional disorders as rectal prolapse, intussusception and solitary rectal ulcer, which are easily shown with defecography but not with other imaging techniques. Proctalgia patients undergo a long workup and many instrumental and radiologic examinations and are finally referred to the proctologist with a condition which is difficult to diagnose and treat. We investigated the defecographic findings and anorectal abnormalities of essential proctalgia, as well as the correlation between radiologic findings, clinical symptoms and efficacy of biofeedback treatment. MATERIALS AND METHODS We retrospectively examined 31 patients (21 women and 10 men; age range: 25-67 years, mean: 46) with defecography, clinico-proctologic investigations integrated with anoscopy and sigmoidoscopy, anorectal manometry and psychological tests. The women were submitted to gynecologic examination: 8 patients had a history of anorectal and pelvic surgery. We did not perform anal electromyography because it may cause painful sphincterial spasms. All patients underwent 30-minute weekly sessions of biofeedback till regression of symptoms. RESULTS Anal pain was described as anorectal in 18 cases, anoperineal in 7, anosphincterial in 5 and rectovaginal in 1 case. It radiated to the sacrum in 42% of cases, thighs in 23%, gluteus muscles in 19%, and was related to evacuation in 39% of cases. Pain lasted some hours (58%) to a few minutes (42%). Manometric data showed sphincterial hypertonia in 14 patients. Eleven patients suffered from anxiety and were on drug treatment. Defecography demonstrated rectocele in 15 cases, puborectalis muscle syndrome in 14, external sphincter spasm in 12, perineal descent in 8, rectal muscosal prolapse in 4, intussusception in 3 and fecal incontinence in 2 cases. After 10 weeks of biofeedback training, all patients reported improvement of symptoms, which was confirmed at manometry as reduced sphincterial pressure. CONCLUSIONS The etiology of essential proctalgia is unknown, but functional disorders of the pelvic floor and sphincterial muscles, as well as altered perineal stasis and pudendal conditions, all play an important role. These data are confirmed in our study where puborectalis syndrome, external sphincterial spasm and perineal descent are involved in over 70% of cases. Defecography is a useful tool because it permits to diagnose abnormal anorectal morphology and to diagnose sphincterial and puborectalis muscle dysfunctions which are missed with other instrumental and imaging techniques.
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Affiliation(s)
- A Salzano
- Dipartimento di Scienze Biomorfologiche e Funzionali, Università degli Studi Federico II, Napoli
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Salzano A, Muto M, De Rosa A, Ginolfi F, Tuccillo M, Carbone M, Amodio F, Rossi E. [Defecography in rectal wall prolapse conditions]. Radiol Med 1999; 97:486-90. [PMID: 10478206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
INTRODUCTION Pelvic floor and rectal prolapse conditions have greatly benefitted by new imaging and instrumental diagnostic approaches, and especially defecography, for both pathophysiological interpretation and differential diagnosis. We investigated the efficacy of defecography in the assessment of rectal prolapse, and in particular the role of videoproctography in diagnosing such dynamic disorders. MATERIAL AND METHODS We selected 224 patients with rectal prolapse from a series of 1,190 consecutive subjects with evacuation disturbances examined in the last 5 years with defecography combined with videoproctography. The patients were 176 women and 48 men ranging in age 32-79 years (mean: 48). Defecography was carried out with Mahieu's technique, but we changed the filter position slightly. Sixty-seven per cent of our patients had been submitted to sigmoidoscopy, but this examination does not usually show rectal intussusception. Occult blood test in feces and double contrast barium enema were carried out in 42% and 38% of cases, respectively, to exclude any organic conditions of colon. RESULTS Mucosal prolapse was more frequent than intussusception (71% and 34%, respectively); rectal walls went out through the anus in 12 cases of anorectal intussusception and thus caused external rectal prolapse. Rectal prolapse was associated with other anorectal alterations, such as rectocele, perineal descent and puborectalis muscle syndrome, in 96 cases. DISCUSSION AND CONCLUSIONS The dynamic changes of ampulla are well depicted by videoproctography, which showed anorectum normalization and spontaneous reduction of invagination after intussusception. Defecography exhibited good capabilities in showing rectal wall function abnormalities. Finally, some features of videoproctography such as low radiation dose, noninvasiveness and ease of execution, make the examination acceptable to patients with anorectal disorders and for the follow-up of rectal prolapse.
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Affiliation(s)
- A Salzano
- Servizio di Radiologia, Osp. Loreto Mare
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Salzano A, De Rosa A, Carbone M, Muto M, Ginolfi F, Rossi E, Amodio F, Tuccillo M. [Computerized tomography features of intestinal infarction: 56 surgically treated patients of which 5 with reversible mesenteric ischemia]. Radiol Med 1999; 97:246-50. [PMID: 10414257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
PURPOSE Bowel infarction is a rare and typical condition of the elderly; despite improvements in diagnostic imaging and vascular surgery, bowel infarction remains a major cause of acute abdomen, with mortality rates ranging 70-80%. Diagnosis is often late because clinical signs, laboratory data and radiologic findings are aspecific. We investigated radiographic and particularly CT patterns of intestinal infarction in 56 patients submitted to surgery within 12 hours of admission. We also report the CT findings of 5 of these patients who had reversible mesenteric ischemia. MATERIAL AND METHODS We retrospectively reviewed 56 cases of bowel infarction. The patients were 29 men and 27 women ranging in age 46-84 years (mean: 63). All the patients were submitted to plain radiography of the abdomen in different projections; emergency CT was carried out with i.v. contrast agent injection. We considered the following CT patterns: dilatation of intestinal loops > 2.5-3 mm, wall thickening > 3-4 mm, intraperitoneal effusion, stuffing of mesenteric vessels with diameter > 3 mm, air-fluid levels. RESULTS Patients in the 7th decade of life were most frequently affected (38 cases), with an overall mortality rate of 59% (33 deaths). Plain radiography showed distention of bowel loops with air-fluid levels in 91% of cases. CT proved to be an accurate technique with higher sensitivity than radiography in detecting mesenteric edema and hemorrhage (68%), abdominal and pelvic effusion (88%), parietal pneumatosis (9%), wall thickening (29%), intraportal gas (7%), and thrombosis of superior mesenteric artery (3.5%). CT patterns in the 5 patients with reversible intestinal ischemia were wall thickening (80%), peritoneal effusion (80%), meteoric dilatatation (40%), a blurred appearance of mesenteric fat (40%). CONCLUSIONS Angiography is a valuable imaging and treatment technique permitting the diagnosis of vascular occlusion and the intraarterial infusion of vasodilators, but it can be carried out in emergency in few centers only. This makes conventional radiology, and particularly CT, the only tool providing useful information for early diagnosis and treatment of bowel infarction. CT is more sensitive than radiography and does not exhibit the limitations of angiography--i.e., invasiveness, radiation exposure and complex organization. Therefore CT can presently be considered the method of choice in patients with suspected bowel infarction.
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Affiliation(s)
- A Salzano
- Servizio di Radiologia, Ospedale Loreto Mare, Università degli Studi Federico II, Napoli
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Esposito S, Mansueto G, Amodio F, Meccariello R, Galasso L, Salzano A, Vallone G. [Duplication of the vena cava inferior with a continuation into the vena azygos. A report of a rare case]. MINERVA CHIR 1999; 54:261-5. [PMID: 10380526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The embryogenesis of the inferior vena cava is a complicated process involving development, regression, anastomosis and replacement of three pairs of venous channels (posterior cardinal, subcardinal and supracardinal). A rare case of concurrent duplication and azygos continuation of the inferior vena cava is presented; it is caused by an altered development of subcardinal and supracardinal venous channels. This anomaly, without other congenital malformations (splenic or cardiac), has been previously described only in six cases in the literature. In this case contrast-enhanced CT enabled the correct diagnosis to be made. The subsequent cavography confirmed the CT report.
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Affiliation(s)
- S Esposito
- Servizio di Radiologia, Ospedale di Pollena, Napoli
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Carbone M, Rossi E, Iurassich S, Amodio F, Gatta G, Brunese L, Coppola V, Vallone G. [Assessment of microvascularization around the plaques in Peyronie's disease with Doppler color ultrasonography, power Doppler and ultrasonography contrast media]. Radiol Med 1999; 97:66-9. [PMID: 10319102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
INTRODUCTION The origin of Peyronie's disease remains obscure although the first report of this condition dates back to 1743. The disease prevalence in 388.6 in 100,000 population and little physiopathologic information is available. Repeated microtrauma to the tunica albuginea appears to favor the onset of inflammatory phenomena which result in fibrosis and calcification. The disease activity produces a microvascularization around the fibrocalcific plaques. We studied the evolution of the inflammatory process in Peyronie's disease relative to clinical symptoms, in order to optimize treatment follow-up. MATERIAL AND METHODS We examined 20 patients with Peyronie's disease aged 34 to 56 years using a GE Sonora Logic 500 MD US scanner with linear probes of 7.5 and 13 MHz. The microvascularization around the plaques was studied with color and power Doppler investigations before contrast agent administration and with combined color and power Doppler after contrast agent administration. We injected Levovist (300 mg/mL) and 10 micrograms prostglandin E1 (PGE1). Examinations were repeated after 2-4 months in the patients with evidence of microvascularization around the plaques. RESULTS US demonstrated fibrocalcific plaques in all the patients. The microvascularization around the plaques was seen with color Doppler in 3 cases (15%), with power Doppler in 5 cases (25%) and with contrast-enhanced color and power Doppler in 7 cases (35%). At 2-4 months' follow-up, we observed slight plaque enlargement and worsened symptoms in 5 of 7 patients (71%) with evidence of some microvascularization around the plaque. CONCLUSIONS The plaque presence allows to define the condition and the microvascularization provides information on its evolution. The disease activity can be distinguished into 3 stages which can be related to the painful symptoms. US exhibits a better cost/benefit ratio than contrast-enhanced MRI.
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Affiliation(s)
- M Carbone
- Dipartimento di Scienze Biomorfologiche e Funzionali, Università degli Studi Federico II, Napoli NA
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Salzano A, De Rosa A, Amodio F, Vallone G, Pinto A, Carbone M, Gesuè G, De Angelis P. [Integrated study of fecal incontinence with defecography, anal ultrasonography, perineography, and manometry]. Radiol Med 1998; 96:574-8. [PMID: 10189919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Imaging methods such as defecography, anal US and perineography, combined with manometry, now permit to identify a growing number of causes of anorectal and pelvic floor deficiency. Fecal incontinence patients can thus be approached correctly relative to both diagnosis and treatment. We investigated the role of these techniques in the work-up of fecal incontinence. MATERIAL AND METHODS Thirty-eight subjects suffering from fecal incontinence were examined. Defecography was carried out with a special commode and videorecorded on a VHS cassette. Anal US was performed with a 7-MHz rotating probe (type 1846) with 3-cm focus length. Perineography was carried out in 15 female patients. RESULTS The anorectal angle (ARA) at rest was increased (mean: 106 degrees; normal range: 90-100 degrees) in 34 cases; involuntary barium leakage was seen in 8 patients, especially on coughing. On squeezing, ARA was normal in 10 cases (mean: 72 degrees; normal range: 60-90 degrees); in 5 cases of puborectal hypotonia there was no angular excursion between rest and squeezing (mean: 105 degrees). During evacuation, the average ARA value was 166 degrees in 21 cases and ARA stretched to verticalization in 8 cases (mean: 179 degrees). Morphofunctional anorectal changes appeared as rectal mucosal prolapse (12 cases), rectocele (10 cases), perineal descent syndrome (8 cases) and external rectal prolapse (3 cases). Anal US identified 15 interruptions in sphincterial rings: 12 patterns were hypoechoic, 2 mixed and 1 hyperechoic. Atrophic thinning of internal anal sphincter was seen in 5 idiopathic incontinence patients. Perineography demonstrated cystocele in 5 cases and cystourethrocele in 1 case. Manometry showed sphincterial hypotonia at rest in 15 cases, lower values of anorectal pressure on squeezing in 8 and smaller air volumes inhibiting external sphincterial tone in 19 cases. CONCLUSIONS Defecographic studies with evaluation of ARA and its changes are an important tool with high diagnostic yield. When combined with other techniques, they provide differential criteria for sphincterial and puborectal causes and permits to identify associated pelvic floor dysfunctions. We believe that defecography, anal US (and perineography in complex disorders) are necessary techniques for the correct clinical approach to fecal incontinence patients, whose role and diagnostic yield are a valid support to manometry.
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Affiliation(s)
- A Salzano
- Servizio di Radiologia, Ospedale Loreto Mare, Università degli Studi Federico II, Napoli
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Rossi E, Carbone M, Iurassich S, Amodio F, Gatta G, Vallone G. [Calcified epithelioma of Malherbe: correlation of clinical characteristics, histologic findings and ultrasonography imaging of 4 cases]. Radiol Med 1998; 96:410-1. [PMID: 9972227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- E Rossi
- Cattedra di Dermatologia, Seconda Università degli Studi, Napoli
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25
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Salzano A, Grassi R, Habib I, Amodio F, De Rosa A, Pinto A, Filidoro L. [The defecographic and clinical aspects of the solitary rectal ulcer syndrome]. Radiol Med 1998; 95:588-92. [PMID: 9717540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Solitary rectal ulcer syndrome is a complex evacuation disorder characterized by a benign ulcerative lesion of the distal rectum; the main symptom is rectal bleeding, but mucus discharge and difficult evacuation may be associated. The clinical, endoscopic and radiologic findings of solitary rectal ulcer syndrome are evaluated in this study. The role of defecography in the diagnosis of mucosal ulceration and morphofunctional alterations such as rectal prolapse and intussusception are investigated. MATERIAL AND METHODS In the last 5 years, 27 patients (19 women and 8 men; mean age: 38 years; range: 13-70 years) complaining of obstructed evacuation and rectal bleeding were examined with fibrosigmoidoscopy with biopsy, and defecography combined with videoproctography. Defecography was carried out sitting the patients on a defecographic chair with the pelvis in lateral projection. The images were acquired at rest, under straining, during squeezing and evacuation. RESULTS Endoscopy and biopsy showed 21 cases of solitary ulcer (77.8%), 3 cases of multiple ulcers (11.1%), 2 cases of granular proctitis (7.4%) and 1 case of pseudopolyp of rectum (3.7%). Among anorectal dynamic alterations, only 1 case (3.7%) of large rectocele was detected at endoscopy under straining. Histo-pathological changes were compared according to Rutter and Riddel criteria; the "colitis cystica profunda" appearance was observed in 2 cases (7.4%). Defecography showed 18 cases (16.6%) of solitary ulcer, 1 case (3.7%) of multiple ulcers and 2 cases (7.4%) of granular proctitis; but it missed 3 cases (11.1%) of small solitary ulcer, 2 cases (7.4%) of small multiple ulcers, and 1 case (3.7%) of pseudopolyp. The dynamic abnormalities shown by defecography were 11 cases (40.7%) of rectal intussusception, 7 cases (25.9%) of recto-anal intussusception, 6 cases (22.2%) of external rectal prolapse and 8 cases (29.6%) of mucosal prolapse. In 16 patients (59.2%) videoprotography emphasized how the ulcer wall was the first to take part in the invagination complex. CONCLUSIONS Double contrast barium enema represents a useful radiologic method to diagnose solitary rectal ulcer, but air insufflation and pharmacological hypotonia prevent the functional study of rectal walls. Endoscopy permits to detect mucosal ulcerations, erythema, pseudopolyps and granular proctitis; biopsy provides an accurate diagnosis. We suggest combined defecography and videoproctography as a useful tool for evaluating solitary rectal ulcer syndrome as a whole; defecography is necessary to identify associated functional abnormalities, such as rectal prolapse and intussusception, not detectable by other instrumental and radiologic investigations and considered by many authors the likely cause of the disease.
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Affiliation(s)
- A Salzano
- Servizio di Radiologia, Ospedale Loreto Mare, Napoli
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Gioiella M, Amodio F, Morena C, Amaturo A, Lemmo I. [Early diagnosis of radiation injuries of the intestine in patients with neoplasms. Various considerations]. MINERVA CHIR 1988; 43:529-32. [PMID: 3399110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Cristallo E, Rizzo A, Palma B, Cifarelli A, Capogrosso V, Amodio F, Colonna L. [WPW syndrome and sinus node dysfunction]. Minerva Cardioangiol 1984; 32:345-53. [PMID: 6472632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Guarini A, Amodio F, Rivetti L, Bonfiglio N. [Clinical experiences in the treatment of arrhythmias with bunaftine (Meregon)]. Minerva Cardioangiol 1975; 23:932-6. [PMID: 1232589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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