[Show abstract][Hide abstract] ABSTRACT: Aim of this study is to present the radiological assessment of the dental pathologies in the Medici Family,to supply evidence of their oral diseases and to verify the efficacy of hygiene methods of the time, providing a term of comparison for other cases. The Medici Project is a paleopathological and historic medical study started in 2004,which is based on the exhumation and analysis of the skeletal remains of the Medici Family buried in the Medici Chapels of Florence. Twelve out of the 21 exhumed individuals were in a state of preservation which permitted to undergo CT and ortopantomography. Pathologic findings were organized in malformations, diffuse parodontopathy, caries, inflammations, and intra-vitam missing teeth.
Dental lesion index (DLI), that is the percentage ratio of the number of damaged teeth out of the total number of examined alveoli, was calculated in all subjects, as absolute value (given as percentage value) as well as age corrected, and compared with DLI of contemporary Aragon family.
Results are arranged for single individuals and for groups of age.The study has shown that all the adults had evident problems in their oral cavities, with values of average age-corrected DLI of 39.27 (males), 41.12(females) and 39.84 (overall).
The presented data show that the Medici Family suffered from poor dental health, despite the use of mouth washes and other “hygienic tools”, and that their DLI was largely worse than the contemporary Aragons, probably protected by the diet and particularly by fluorine assumed with waters.
Full-text · Article · Aug 2013 · Journal of Forensic Radiology and Imaging
[Show abstract][Hide abstract] ABSTRACT: A paleopathological study was carried out on the she skeletal remains of Cardinal Carlo de' Medici (1595-1666), son of the Grand Duke Ferdinando I (1549-1609) and Cristina from Lorraine (1565-1636), to investigate the articular pathology described in the archival sources.
The skeletal remains of Carlo, buried in the Basilica of San Lorenzo in Florence, have been exhumed and submitted to macroscopic and radiological examination.
The skeleton of Carlo revealed a concentration of different severe pathologies. Ankylosis of the cervical column, associated with other facial and spine anomalies suggests a diagnosis of congenital disease: the Klippel-Feil syndrome. In addition, the cervical segment presents the results of the tuberculosis (Pott's disease) from which the Cardinal suffered in his infancy. The post-cranial skeleton shows an ankylosing disease, mainly symmetrical and extremely severe, involving the large as well as small articulations, and characterized by massive joint fusion, that totally disabled the Cardinal in his last years of life.
The final diagnosis suggests an advanced, ankylosing stage of rheumatoid arthritis.
Full-text · Article · Jun 2013 · Clinical and experimental rheumatology
[Show abstract][Hide abstract] ABSTRACT: This is a paleopathological study of spinal diseases in a high-social class Renaissance sample to detect the incidence of vertebral pathology affecting the members of the Medici family in Florence and to investigate the possible causes. Except for a case of tuberculosis attested by archival documents no data about the spinal diseases of this sample were known before the exploration of the Medici burials in San Lorenzo (Florence). The skeletal remains were submitted to macroscopic investigation and radiological examination. A series of spinal diseases were diagnosed, including congenital lesions (Klippel-Feils syndrome, scoliosis, spina bifida occulta, coccyx sacralization, coccyx angulation), degenerative changes (osteoarthitis and Schmorls nodes), metabolic disorders (Diffuse Idiopathic Skeletal Hyperostosis) and infectious disease (Potts disease).
We have a complete picture of severe spinal pathology affecting an aristocratic class of the Italian Renaissance. Some of these spinal diseases are related to the lifestyle of the members of this family, which practiced horse back riding and hunting, with consequent mechanical stress. They also consumed a high-calorie diet.
Full-text · Article · Jun 2010 · Paleopathology newsletter
[Show abstract][Hide abstract] ABSTRACT: The remains of 12 members of the grand ducal (junior) branch of the Florentine Medici family were exhumed in 2003 as part of the Medici Project, a multidisciplinary study whose aim was to investigate the lifestyles, health status, and possible causes of death of members of one of the richest, most powerful families of the Italian Renaissance. Digital radiography and orthopantomography were performed on the skeletal remains of individuals who lived between 1562 and 1666. The observed bone malformations, deformities, and changes (degenerative, metabolic, and dental) challenge traditional views, based on portraits and historical accounts, about the appearance and lifestyle of some family members. Moreover, the occurrence of a constellation of bone changes related to diabetes (osteoporosis, osteoarthritis, diffuse idiopathic skeletal hyperostosis, cranial hyperostosis, and crystalline arthropathy) suggests that this metabolic disease was common in the grand ducal branch of the Medici family.
[Show abstract][Hide abstract] ABSTRACT: We report a case of osteochondritis dissecans in the patella of Francesco de' Medici, Prince of Capistrano, who lived from 1594 to 1614. He was known to play Florentine kick ball, a precursor of Rugby and American football, and speculate that trauma from this activity may have led to the lesion.
[Show abstract][Hide abstract] ABSTRACT: Diffuse idiopathic skeletal hyperostosis (DISH) is a common systemic disorder characterised by the ossification of the anterior longitudinal spinal ligament involving at least three contiguous vertebrae and by diffuse extraspinal enthesopathies. The condition is associated with the male sex and with advanced age; its aetiology is uncertain, but seems to be related to obesity and diabetes. The most recent studies in archaeological series demonstrated a relation between high social status and the incidence of DISH. The present study examines two cases of DISH found amongst the members of the Medici family buried in the Basilica of San Lorenzo in Florence. The skeletons of the Grand Dukes Cosimo I (1519-1574) and his son Ferdinand I (1549-1609) showed the typical features of the condition. This result is related to the obesity of the Grand Dukes, attested by the written and artistic sources, and to the protein-based alimentation demonstrated by a paleonutritional study, thus furnishing further evidence to the significance of DISH as a life style.
Full-text · Article · Sep 2009 · European Spine Journal
[Show abstract][Hide abstract] ABSTRACT: To analyze at computed tomography (CT) examination the "sump effect," a particular type of transient hepatic attenuation differences, related primarily to an increase in arterial flow without any accompanying decrease in portal flow.
We retrospectively evaluated all biphasic upper abdomen CT examinations (1283 in 807 patients) performed from the year 2003 to the year 2006 and selected and organized those with at least 1 transient hepatic attenuation differences. Of these, we enrolled patients with lobar/multisegmental arterializations surrounding focal lesion(s), without CT portal hypoperfusion signs, in the study group. We assessed histology, number, site, diameter, and volume of causing focal lesion(s); site, extension, and attenuation of arterial area; greater visibility of feeding artery branches ipsilateral to causal focal lesion; and presence of aberrant left hepatic artery. Thirty patients with normal liver represented the control group.
Fifteen of the 99 patients with transient hepatic attenuation differences presented with sump effect. In our series, this phenomenon was always related to hypervascular inflammatory and benign lesion(s) with overall average diameter of 8 +/- 4 cm inscribed in arterial area. Attenuation of arterial enhanced areas were significantly higher than the contralateral parenchyma and control patients' parenchyma, with frequent hypertrophy of ipsilateral arterial feeding branches and/or aberrant left hepatic artery visibility.
Siphonage seems to be primary hyperperfusion area determined by arterial bed enlargement, induced by inscribed large hypervascular inflammatory/benign lesion(s).
Full-text · Article · Mar 2009 · Journal of computer assisted tomography
[Show abstract][Hide abstract] ABSTRACT: According to the written sources several members of the famous Medici family of Renaissance Florence suffered from an arthritic disease, called 'gout' by contemporary physicians; a palaeopathological study allowed verification of the true nature of the 'gout of the Medici' referred by archive document data.
The skeletal remains of the Grand Dukes and their families, buried in the Basilica of San Lorenzo in Florence, were examined macroscopically and submitted to X-ray investigation.
Out of 15 investigated individuals, two cases of diffuse idiopathic skeletal hyperostosis (DISH), with ossification of the anterior longitudinal ligament and massive hyperostotic changes of the extra-spinal ligaments, were detected in the skeletons of the Grand Dukes Cosimo I (1519-74) and his son Ferdinand I (1549-1609). The left foot of Ferdinand also revealed typical lesions of the uratic gout, confirming the archive data, which describe the disease in detail.
The association between DISH and elite status, highlighted in recent research, receives further confirmation in the present study, furnishing evidence to the significance of this disorder as a lifestyle indicator, linked specifically with a high-caloric diet, consequent obesity and type II diabetes mellitus. Furthermore, the coexistence between DISH and gout observed in Ferdinand represents the first documentation of this association in the palaeopathological literature.
Full-text · Article · Feb 2009 · Rheumatology (Oxford, England)
[Show abstract][Hide abstract] ABSTRACT: To report our experience with computed tomography colonography (CTC) systematically performed in subjects with positive faecal occult blood test (FOBT) and an incomplete colonoscopy in the setting of a population-based screening for colorectal cancer (CRC).
From April 2006 to April 2007, 43290 individuals (age range 50-70) who adhered to the regional screening program for the prevention of CRC underwent immunochemical FOBT. FOBT was positive in 1882 subjects (4.3%). 1463 (77.7%) of these subjects underwent colonoscopy, 903 performed in a single center. Of 903 colonoscopies 65 (7.2%) were incomplete. Forty-two of these subjects underwent CTC. CTC was performed with a 16-MDCT scanner after standard bowel prep (polyethyleneglycole) in both supine and prone position. Subjects whose CTC showed polyps or masses were referred to the endoscopist for repeat colonoscopy under sedation or underwent surgery. Per-lesion and per-segment positive predictive values (PPV) were calculated.
Twenty-one (50%) of 42 CTCs showed polyps or masses. Fifty-five of these subjects underwent a repeat colonoscopy, whereas 2 subjects underwent surgery for colonic masses of indeterminate nature. Four subjects refused further examinations. CTC correctly identified 2 colonic masses and 20 polyps. PPV for masses or polyps greater than 9 mm was of 87.5%. Per-lesion and per-segment PPV were, respectively, 83.3% and 83.3% for polyps greater or equal to 10 mm, and 77.8% and 85.7% for polyps of 6-9 mm.
In the context of a screening program for CRC based on FOBT, CTC shows high per-segment and per-lesion PPV for colonic masses and polyps greater than 9 mm. Therefore, CTC has the potential to become a useful technique for evaluation of the non visualized part of the colon after incomplete colonoscopy.
Full-text · Article · Aug 2008 · World Journal of Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: This paper reports our early experience in the treatment of haemoptysis with embolization of the bronchial arteries using detachable coils.
Ten patients (mean age 45 years, range 23-83) with haemoptysis due to bronchoscopic biopsy of indeterminate lung nodules, lung cancer, tubercular bronchiectasis, cystic bronchiectasis or sarcoidosis underwent embolization of the bronchial arteries responsible for the bleeding using detachable coils. Patients were followed-up for a median of 14 months.
In all patients the procedure halted the bronchial bleeding within 24 hours. Eight patients had no recurrence of haemoptysis. In one patient with lung cancer and another with sarcoidosis, haemoptysis recurred within 1-3 months due to recruitment of additional feeding arteries and to a missed large feeding artery originating from the subclavian artery, which required a new procedure.
Use of detachable coils for embolization of bronchial arteries in patients with haemoptysis is advantageous since it eliminates the risk of migration typical of other embolic materials and enables rapid and permanent vessel occlusion.
No preview · Article · May 2008 · La radiologia medica
[Show abstract][Hide abstract] ABSTRACT: In magnetic resonance diffusion-weighted imaging, signal intensity is influenced simultaneously by temperature, diffusivity, b value, pseudodiffusion, macroscopic motion, and T2-weighted intensity value. The purpose of this pictorial essay is to discuss and exemplify the influence that such factors and the related modifications have on signal intensity. Apparent diffusion coefficient, shine-through and pseudodiffusion will also be examined to show how T2-weighted signal intensity value and nondiffusional intravoxel incoherent motion can affect the diffusion-weighted imaging.
No preview · Article · May 2008 · Journal of Computer Assisted Tomography
[Show abstract][Hide abstract] ABSTRACT: Computed tomography (CT) is the most sensitive imaging technique for detecting lung nodules, and is now being evaluated as a screening tool for lung cancer in several large samples studies all over the world. In this report, we describe a semiautomatic method for 3-D segmentation of lung nodules in CT images for subsequent volume assessment. The distinguishing features of our algorithm are the following. 1) The user interaction process. It allows the introduction of the knowledge of the expert in a simple and reproducible manner. 2) The adoption of the geodesic distance in a multithreshold image representation. It allows the definition of a fusion--segregation process based on both gray-level similarity and objects shape. The algorithm was validated on low-dose CT scans of small nodule phantoms (mean diameter 5.3--11 mm) and in vivo lung nodules (mean diameter 5--9.8 mm) detected in the Italung-CT screening program for lung cancer. A further test on small lung nodules of Lung Image Database Consortium (LIDC) first data set was also performed. We observed a RMS error less than 6.6% in phantoms, and the correct outlining of the nodule contour was obtained in 82/95 lung nodules of Italung-CT and in 10/12 lung nodules of LIDC first data set. The achieved results support the use of the proposed algorithm for volume measurements of lung nodules examined with low-dose CT scanning technique.
Full-text · Article · Feb 2008 · IEEE Transactions on Information Technology in Biomedicine
[Show abstract][Hide abstract] ABSTRACT: Hemolymphangioma is a tumor composed of lymphatic and hematic cells. Signs and symptoms of this tumor are poor; physical examination reveals splenomegaly, and laboratory-hematic analysis shows mild thrombocytopenia without antiplatelet antibodies. Magnetic resonance imaging after administration of a superparamagnetic contrast agent can be used for the splenic pathology. The use of a T2 dual-purpose contrast agent composed of superparamagnetic iron-oxide particles is preferred. Superparamagnetic iron-oxide particles have a strong effect on the shortening of both T1 and T2 relaxation times. Hemolymphangiomatosis must be differentiated from the other primary vascular neoplasms of the spleen. The primary malignant vascular neoplasm of the spleen is angiosarcoma, but the more common neoplastic disorder of the spleen is lymphoma. These pathologies are described on CT/MR imaging only after using iodinated/paramagnetic contrast agents. After administration of the contrast agent, three patterns of enhancement have been described: immediate, homogeneous enhancement; early peripheral enhancement with uniform delayed enhancement; and peripheral enhancement with centripetal progression. Splenic hemolymphangiomatosis is a very rare pathology whose sonography, basal MRI, and late CT contrastographic features may resemble those of other diffuse benign vascular neoplasms. On the other hand, it is not possible to demonstrate a real hemangioma-like enhancement during the vascular phase. Moreover, its late contrastographic pattern can be considered at least very indicative if CT and iron-oxide-enhanced MRI are applied as complementary diagnostic tools.
[Show abstract][Hide abstract] ABSTRACT: Diffusion and magnetization transfer (MT) techniques have been applied to the investigation with MR of epilepsy and have revealed changes in patients with or without abnormalities on MR imaging. We hypothesized that also in the coeliac disease (CD), epilepsy and cerebral calcifications (CEC) syndrome diffusion and MT techniques could reveal brain abnormalities undetected by MR imaging and tentatively correlated to epilepsy.
Diffusion and MT weighted images were obtained in 10 patients with CEC, 8 patients with CD without epilepsy and 17 healthy volunteers. The whole brain apparent diffusion coefficient (ADC) and MT ratio (MTR) maps were analyzed with histograms and the Statistical Parametric Mapping 2 (SPM2) software. We employed the non-parametric Mann-Whitney U test to assess differences for ADC and MTR histogram metrics. Voxel by voxel comparison of the ADC and MTR maps was performed with 2 tails t-test corrected for multiple comparison.
A significantly higher whole brain ADC value as compared to healthy controls was observed in CEC (P = 0.006) and CD (P = 0.01) patients. SPM2 showed bilateral areas of significantly decreased MTR in the parietal and temporal subcortical white matter (WM) in the CEC patients.
Our study indicates that diffusion and MT techniques are also capable of revealing abnormalities undetected by MR imaging. In particular patients with CEC syndrome show an increase of the whole brain ADC histogram which is more pronounced than in patients with gluten intolerance. IN CEC patients, voxel-based analysis demonstrates a localized decrease of the MTR in the parieto-temporal subcortical WM.
Full-text · Article · Apr 2007 · American Journal of Neuroradiology
[Show abstract][Hide abstract] ABSTRACT: Oxygen-ozone therapy exploits the chemical properties of ozone, an unstable allotropic form of oxygen with the symbol O3 and a molecular weight of 48 kDa. Many biologic effects have been attributed to ozone: increased glycolysis, effects on red blood cells, effects on rheology, bactericidal, fungicide and virustatic, immunomodulating action and analgesic and anti-inflammatory effects. This broad spectrum of action explains the many indications for medical ozone administration. We assessed the results obtained in treating 15,000 patients with oxygen-ozone therapy and in particular to describe possible complications or collateral effects. The only thing we can understand is that the authors did not use correct asepsis and hygiene procedures. Hence, the low costs of oxygen-ozone therapy and the lack of any complications or collateral effects make this minimally invasive procedure safe and useful for the treatment of lumbar disc herniation.
No preview · Article · Apr 2007 · International Journal of Ozone Therapy
[Show abstract][Hide abstract] ABSTRACT: Within the framework of the Medici Project, a paleopathological team of experts from the University of Pisa, the University of Florence and the Superintendence for Florentine Museums, is carrying out a study on 49 tombs of some of the Medici family members (16th-18th centuries) housed in the so-called Basilica of San Lorenzo in Florence. The project involves disciplines such as paleopathology, funerary archeology, physical anthropology, paleonutrition, parasitology, histology, histochemistry, immuno-histochemistry, electron microscopy, molecular biology, and identification of ancient pathogens. The most recent biomedical imaging technologies have been employed to obtain as much information as possible about the genetic make-up, eating habits, life styles and diseases of these important rulers of Renaissance Florence. The first anthropological and paleopathological results are presented here.
Full-text · Article · Feb 2007 · Medicina nei secoli
[Show abstract][Hide abstract] ABSTRACT: The life, activity and specimens of Girolamo Segato (Sospirolo 1792--Firenze 1836), as well as the mystery still surrounding his petrifaction method are outlined in this paper with the aim of shedding some light on one of the most controversial naturalists of the 19th century. Even if after his death many preparations became scattered or even destroyed, the greatest nucleus of them is now collected and exhibited in the Museum of the Department of Anatomy in Florence. Special attention has been given to the description of one of the most famous "pieces", a female head, recently added to the collection, coming from Museo Civico of Belluno. This sample, submitted to conventional Rx analysis and CT Scan Tomography, displays an outstanding injection of the thinnest peripheral blood vessels.
No preview · Article · Jan 2007 · Italian journal of anatomy and embryology = Archivio italiano di anatomia ed embriologia