3T MR Angiography and ASL Perfusion in primary angiitis of the central nervous system

Primary angiitis of the central nervous system (PACNS) is a rare and ill-defined disease. Headache and encephalopathy are the most frequent symptoms at onset. Neuroimaging plays an important role in the diagnosis but the pattern of abnormal findings is often not specific and diagnosis required brain biopsy. MRA is a reasonable initial modality in the investigation of suspected CNS vasculitis. 3T MRA offers increased signal to noise ratio with better background suppression, leading to better depiction of the intracranial circulation. We estimate the usefulness of MRA and ASL analysis in the diagnosis of PACNS at 3T

Termoablazione del polmone:confronto sperimentale in vivo fra ablazione con microonde e ablazione a radiofrequenza

OBIETTIVO:confrontare le procedure di termoablazione con microonde(MW) e radiofrequenza (RF) in termini di praticabilità,sicurezza e efficacia in uno studio sperimentale condotto in vivo su coniglio. METODO:20 conigli divisi in due gruppi da 10 sono stati sottoposti alla ablazione con MW (gruppo A) e a RF(gruppo B).Si è effettuata sotto guida TAC una singola ablazione del tessuto polmonare.Per la procedura sono stati utilizzati un prototipo per la ablazione con MW(viva- wave,Tyco Healthcare)e un sistema di ablazione con RF disponibile commercialmente(cool-tip, Tyco Healthcare).Il sacrificio è stato effettuato dopo 3 giorni (gruppoA=5,gruppo B=5) e dopo 7 giorni (gruppoA=5,gruppoB=5). RISULTATI:l'operazione è stata portata a termine in 9 casi su 10 in entrambi i gruppi.Il fal- limento negli altri due casi è stato a causa di decesso per stress anestesiologico(gr.A) e per pneumotorace(gr.B).Un coniglio del gruppo B è morto 24 ore dopo la procedura per grave emotorace.Le complicazioni nel post-operatorio sono state pneumotorace(gr.A=4,gr.B=4), ascesso(grA=1,gr.B=1)e ustione della parete toracica (gr.A=4).Il diametro maggiore della necrosi è stato di 12,1 mm +/- 3,2mm nel gr. A e di 14,8mm +/- 4,9mm nel gr. B.L'esame anatomopatologico ha evidenziato in entrambi i casi:necrosi focale,edema,emorragia e infiltrato linfocitario periferico.Il diametro perilesionale di trombosi dei piccoli vasi è maggiore per il gruppo A rispetto al gruppo B.Gli altri organi non sono stati danneggiati. CONCLUSIONI:la praticabilità e la sicurezza delle MW e della RF sono simili nel modello animale,come anche l'aspetto anatomopatologico,che ha comunque evidenziato una trombosi dei piccoli vasi circondanti la lesione maggiore negli animali sottoposti alla ablazione con microonde

Morphologic study of the cornea by in vivo confocal microscopy and optical coherence tomography after bifocal refractive corneal inlay implantation

To evaluate the biocompatibility of the Flexivue Microlens intracorneal inlay based on healing of corneal wounds and analysis of corneal structural features using in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT)

PARTECIPAZIONI SOCIETARIE. ASPETTI ECONOMICO-AZIENDALI E GIURIDICI

Il presente lavoro evidenzia il significato economico-aziendale del possesso di partecipazioni. A tal proposito vengono descritte le diverse strategie di sviluppo che possono essere intraprese dalle unità produttive. In tale ambito si inseriscono infatti le operazioni di acquisizione delle partecipazioni, e in particolare l’operazione di compravendita delle stesse. In seguito alla spiegazione economico-aziendale delle possibili motivazioni che spingono all’acquisizione di quote di capitale di altre unità produttive, mano a mano ci spingeremo in aspetti sempre più tecnici. L’analisi approfondisce il tema della compravendita delle partecipazioni con riferimento a ciascun tipo societario previsto dal nostro ordinamento. Tuttavia, occorre precisare che non si guarderà alla disciplina dell’acquisto di partecipazioni secondo una logica squisitamente giuridica, piuttosto si adotterà un’ottica tecnico-professionale. Infine, si propone una panoramica dei diversi criteri valutazione delle partecipazioni all’interno del bilancio di esercizio. Per apprezzare la concreta rilevanza delle considerazioni avanzate, a completamento e conclusione del presente lavoro sono presentati i risultati di un’analisi empirica effettuata su 91 organismi economici toscani di rilevanti dimensioni. Tale studio, in particolare, è volto ad indagare la rilevanza in concreto del fenomeno partecipativo e mettere in luce le relative problematiche di valutazione in bilancio

Aceclidine, brimonidine tartrate, and dapiprazole: comparison of miotic effect and tolerability under different lighting conditions

PURPOSE: To evaluate the effect of 3 types of topically applied miotic eyedrops on the pupil diameter in normal eyes. SETTING: Department of Neurosciences, Section of Ophthalmology, University of Pisa, Pisa, Italy. METHODS: This prospective study comprised 60 eyes of 30 healthy volunteers treated with aceclidine 0.02%, brimonidine tartrate 0.20%, and dapiprazole 0.25%. Pupil diameter was measured under scotopic, mesopic (4 lux), and photopic (50 lux) conditions using an infrared pupillometer incorporated into a CSO topographer. The first measurement was obtained before single instillation of 1 type of miotic eyedrop. Subsequent measurements were taken after 30, 120, and 240 minutes. Each additional medication was tested after an interval of at least 6 weeks to avoid possible effects from the previously administered drug. All patients received a questionnaire and were asked to grade the tolerability of each eyedrop using a subjective scoring system. RESULTS: Aceclidine 0.02% had no significant miotic effect. Brimonidine tartrate 0.20% caused significant miosis within 30 minutes and 120 minutes; after 240 minutes, the effect under all luminance conditions decreased to baseline levels without reaching the initial level. Dapiprazole 0.25% had a miotic effect similar to that of brimonidine but produced many side effects including hyperemia and burning, which many patients said caused significant discomfort. CONCLUSIONS: Brimonidine tartrate 0.20% had the best miotic effect of the 3 agents tested and was well tolerated by the patients. The reproducible miotic effect of brimonidine tartrate under all lighting conditions might benefit postoperative refractive patients who report night-vision difficulties related to large pupils

Aceclidine, brimonidine tartrate, and dapiprazole: comparison of miotic effect and tolerability under different lighting conditions.

Purpose: To evaluate the effect on pupil diameter of three different miotic eye-drops: aceclidine, brimonidine tartrate 0.20% and dapiprazole, when applied topically in normal subjects Methods: The eyes of 30 healthy volunteers were included in this study. Pupil diameter was measured under scotopic, mesopic (4 lux) and photopic (50 lux) conditions, using an infrared pupillometer, in conjunction with a CSOTM topographer. The first measurement was obtained before the sole instillation of the three different kinds of eye drops. Afterwards, measurements were performed after 30, 120 and 240 minutes. Each additional eye medication was tested further after at least a 10 day interval in order to avoid any possible drug interference. Every patient received a questionnaire to grade the tolerability of each kind of eye drops by a subjective scoring system. Results:Aceclidine had an unimportant miotic effect. Brimonidine caused significant miosis within 30 and 120 minutes: then the effect reduced without reaching the initial baseline at the forth hour in all different luminance conditions. Dapiprazole had a quite similar miotic effect to brimonidine but it produced many side effects, including hyperemia and burning, which caused too much discomfort for most of patients. Conclusions: Brimonidine tartrate 0.20% seems to have the best miotic effect together with good patient tolerability in comparison with aceclidine and dapiprazole. The reproducible miotic effect of this eye drop under all lighting conditions might help postoperative refractive patients who report night-vision difficulties related with large pupils

Visual field global indices and heidelberg retinal tomograph II parameters after glaucoma surgery

Purpose: To detect and quantify changes in optic nerve morphology after glaucoma surgery, using Heidelberg Retina Tomograph (HRT), and in visual field global indices, using Humphrey perimeter. Methods: The authors enrolled 14 adult patients with chronic open-angle glaucoma (PAOG) undergoing incisional glaucoma surgery, such as trabeculectomy and deep sclerectomy, for progressive glaucoma damage. Intraocular pressure (IOP), visual field and HRT were performed 2 weeks before surgery and then repeated 3 and 6 months after. Results: Our clinical trial evidenced a IOP reduction superior to 40% after glaucoma surgery. The pre-operative average IOP was 24.36 ± 5 mmHg: 3 months after surgery average IOP was 12.07 ± 3.12 mmHg, while it was reduced to 10.64 ± 2.84 mmHg after 6 months. Changing in optic nerve morphology parameters, using Heidelberg Retinal Tomograph, revealed a significant increase in the overall mean RNFL thickness, in Rim Area and Rim Volume, whereas Cup Area, Cup Volume, Cup/Disc Area Ratio, and Maximum Cup Depth decreased. Visual field functional global indices, such as MD and PSD, improved a little bit less than morphological indices. In 57% of our patients we discovered an improvement of all the considered parameters. Multiple linear regression analysis demonstrated that, among the optic disk sectors, the temporal and the super nasal octant improved in direct proportion to the magnitude of IOP reduction. The improvement appeared to be significant in the first 3 months of follow-up, probably because of the immediate IOP reduction after surgery. By HRT, we noticed an increase in retinal fibres of 0.9 microns and of 0.4 microns every mmHg of IOP reduction, respectively in the first 3 months and in the second period of follow-up. Moreover, between risk factors, such as age, pre-surgery MD, IOP variation, the last one was the most important in changing of optic disc parameter. Regarding visual field global indices, we registered an average evolution from the 4th to the 3rd - 4th stage, using the Brusini Glaucoma Staging System. Conclusions: Our study demonstrated the beneficial effect of IOP reduction, obtained with glaucoma surgery techniques, as trabeculectomy and deep-sclerectomy, on visual field global indices and optic disc parameter evaluated by Heidelberg Retinal Tomograph

Abducens nerve palsy in a congenital anomalous neurovascular development of the sixth cranial nerve and anterior inferior cerebellar artery: A case report

Abducens nerve palsy is a common ocular motor paralysis with a broad set of etiopathogenetic causes. Magnetic resonance imaging is a key diagnostic technique to investigate organic causes of sixth nerve palsy, as it allows a detailed representation of the course of the nerve, particularly in its intracisternal tract. Anatomical variants of the sixth cranial nerve comprise duplications and fenestrations in various traits. Anatomical variants of cerebellar arteries have also been described. We report the case of a patient with abducens nerve palsy presumably related to a neurovascular conflict due to a peculiar anatomical variant, which consists in a cerebellar artery passing through the intracisternal duplication of the abducens nerve