Early effects comparison of X-rays delivered at high-dose-rate pulses by a plasma focus device and at low dose rate on human tumour cells.

A comparative study has been performed on the effects of high-dose-rate (DR) X-ray beams produced by a plasma focus device (PFMA-3), to exploit its potential medical applications (e.g. radiotherapy), and low-DR X-ray beams produced by a conventional source (XRT). Experiments have been performed at 0.5 and 2 Gy doses on a human glioblastoma cell line (T98G). Cell proliferation rate and potassium outward currents (IK) have been investigated by time lapse imaging and patch clamp recordings. The results showed that PFMA-3 irradiation has a greater capability to reduce the proliferation rate activity with respect to XRT, while it does not affect IK of T98G cells at any of the dose levels tested. XRT irradiation significantly reduces the mean IK amplitude of T98G cells only at 0.5 Gy. This work confirms that the DR, and therefore the source of radiation, is crucial for the planning and optimisation of radiotherapy applications.

Radiation protection of PFMA-1, a plasma focus for medical applications.

A plasma focus is being developed for breeding short-lived radionuclides. The different radiation protection issues and concerns posed by the machine once in operation are analysed and discussed. Activation is shown to be totally negligible and likewise neutron emission is found to pose no concern at all. The only source of radiation risk is found to rest in the radionuclides produced, 18F and 15 O, generating a peak exposure of 1.114 Sv y(-1) at the distance of closest approach of 2.5 m. Shielding to protect against this hazard is calculated to be 5 cm Pb or 54 cm concrete for the operation area and 5.5 cm Pb for the transportation flask.

[Severe combined immunodeficiencies: a case of adenosine-deaminase deficit]. / Le immunodeficienze combinate gravi: descrizione di un caso clinico di deficit di adenosin deaminasi.

Severe combined immunodeficiencies (SCID) are a group of rare genetic disorders characterized by profoundly defective T lymphocyte. We described in a two months old male a case of SCID with ADA deficiency. With this new case report we summarize recent developments in immunodeficiencies therapy, aiming to induce to bear in mind this disorder, despite its rarity, in differential diagnosis of infections, particularly respiratory or gastrointestinal infections.

Cardiac angiosarcoma: early diagnosis. A case report.

Malignant tumours are rare and their diagnostic verification is more frequent at a post-mortem examination. We present a clinical case of a angiosarcoma of the atrium dextrum in a patient where the diagnosis was done precociously. The clinical case we are describing presents some characteristics not noted in literature. The patient did not present any other clinical signs other than giving assumption of the presence of neoplasm and/or secondary localization. The transthoracic echographic exam revealed the methodology to enable the removal of the neoplasm, the outline of which, was better defined with the transesophageal probe.

Applying object-oriented technologies in modeling and querying temporally oriented clinical databases dealing with temporal granularity and indeterminacy.

The need of managing temporal information given at different levels of granularity or with indeterminacy is common to many application areas. Among them, we focus on clinical data management. Different time granularities and indeterminacy are also needed in querying temporal databases. In this paper, we describe GCH-OSQL (Granular Clinical History-Object Structured Query Language), an object-oriented temporally-oriented extension of SQL. GCH-OSQL is based on an object-oriented temporal data model, GCH-OODM. GCH-OODM allows storage of clinical information at different and mixed granularities or with temporal indeterminacy. GCH-OSQL deals with the valid time of clinical information. The temporal extension of the SELECT construct includes the addition of the TIME-SLICE and MOVING WINDOW clauses, and the capability to reference the temporal dimension of objects in the WHERE and SELECT clauses. Using object-oriented technologies, a system prototype for GCH-OSQL and GCH-OODM has been implemented and applied to data management of follow-up patients after coronary angioplasty intervention.

[Familial aortic dissection in a young woman. A clinical case and review of the literature]. / La dissecazione dell'aorta di origine familiare in una giovane donna. Caso clinico e revisione della letteratura.

A case report of aortic dissecting aneurysm in a 29-years-old woman is described. The father died of rupture of a dissecting aneurysm with acute hemopericardium at the age of 46 years. Histologic examination of the aortic wall revealed a loss of mucopolysaccharide-like material in the media and cystic medial changes. This dramatic familial cluster of aortic dissecting aneurysm suggests a genetically inherited disease although the basic defect remains to be found out.

Querying temporal clinical databases with different time granularities: the GCH-OSQL language.

There is a need for managing temporal clinical information given at different levels of granularity. Different time granularities are also needed in querying clinical databases. In this paper, we describe GCH-OSQL (Granular Clinical History--Object Structured Query Language), an object-oriented temporally-oriented extension of SQL. GCH-OSQL is based on an object-oriented temporal data model. It allows storage of clinical information at different and mixed granularities. GCH-OSQL deals with the valid time of clinical information. GCH-OSQL offers also a graphical user-interface. It guides different end users, from expert to naive, to formulate expressive and correct queries.

[Cardiotoxicity caused by radiation. Description of 2 clinical cases]. / Cardiotossicità da radiazioni. Descrizione di due casi clinici.

The paper reports two cases of valvular cardiac lesions and pericardial effusion caused by radiation. The widespread use of radiotherapy makes this a highly relevant problem. Radiation most frequently causes damage to the pericardium leading to pericardial effusion, and in some cases provokes myocardial, valvular and coronary lesions and even myocardial infarction. Cardiotoxicity depends on the radiation dose which must generally exceed 40 Gy. Radiated patients must be carefully monitored so as to diagnose cardiac lesions at an early stage. The ongoing improvement of radiotherapy techniques is the best means of preventing cardiac damage due to radiotherapy.

[The exposure dose of the sella turcica in panoramic dental radiography with an intraoral radiogenic source]. / La dose di esposizione alla sella turcica in radiografia panoramica dentaria con sorgente radiogena intraorale.

Panoramic dental radiography using an intraoral X-ray source exposes critical organs, such as the crystalline and the thyroid, as well as organs of fundamental importance such as the pituitary gland, to X-rays. An experimental study was carried out to assess the exposure dose to the sella turcica during the radiological examination of the upper and lower dental arches using an X-ray source within the oral cavity. The comprehensive exposure dose for the upper and lower dental arches exceeded that found in orthopantomography (110 micro Gy/examination vs 47 micro Gy/examination) with errors which are respectively inferior to 15% and 30%. The authors conclude that the risk of provoking anatomical or functional changes of the pituitary gland is extremely remote using this type of examination.

[Ionizing radiation absorbed by the patient]. / Radiazioni ionizzanti assorbite dal paziente.

The aim of this study is to evaluate the skin contact dose to which the patient is exposed during an endo-oral radiography using the long cone technique (paralleling technique) and the short cone technique (bisecting angle technique). Measures were taken in 50 dental X-ray units with a range of tension from 50 to 70 Kvs. Measures were taken using a calcium fluoride thermoluminescent dosimeter (CaF2:Dy). Data are expressed in uGy/mA.sec., divided in relation to the tension's values and the kind of technique used. This study reveals that the bisecting technique presents higher doses (2-3 times higher) than the long cone technique (paralleling technique).

[Fibrinogen, a cardiovascular risk factor]. / Il fibrinogeno fattore di rischio cardiovascolare.

Fibrinogen level is an independent predisposing factor for coronary heart disease and has a prognostic significance comparable with that of cigarette smoking, serum cholesterol level and hypertension. In our study fibrinogen levels were measured in 45 patients with cardiovascular disease of which 25 (55%) had a high fibrinogen level and in 45 persons healty, of which only 3 (6.6%) increased fibrinogen. The impact of fibrinogen level on the risk of cardiovascular disease was more consistent in men of all ages considered. The authors note that the independent contribution of fibrinogen to the cardiovascular risk may reflect hypercoagulability, hyperviscosity and increased platelet aggregation. Therefore they consider, the dosing of fibrinogen level important in the research of cardiovascular risk factors.

[Right atrial myxoma: echocardiographic diagnosis and review of the literature. Description of a clinical case]. / Mixoma atriale destro: diagnosi ecocardiografica e revisione della letteratura. Descrizione di un caso clinico.

Two-dimensional echocardiography is the method of first choice for diagnosing right atrial myxoma. A case of right atrial myxoma, documented by two-dimensional echocardiography, is here presented. Two-dimensional echocardiography allows accurate assessment of, tumor size, site of attachment, mobility and consistency. This non-invasive technique has replaced angiocardiography in the routine preoperative evaluation of these cases. The myxomatous nature of the mass was confirmed at surgery.