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We give an overview of the EDA CAT B R&D project ""Signal Processing for Enhanced Radar Imaging"" (SPERI). In this project, the benefits of applying two super-resolution methods Super Spatially Variant Apodization (SSVA) and Compressed Sensing (CS) to two-dimensional Inverse Synthetic Aperture Radar (ISAR) images of airborne radar targets were investigated with respect to the improvements in automatic target identification rates. The algorithms have been tested over a database of more than 1200 real radar images.

The relevance of the religious dimension in the education to universal citizenship (Giorgia Pinelli, Michele Caputo, Maria Teresa Moscato – Università di Bologna) This essay highlights the potential role of the religious dimension in the positively utopian hypothesis of an education to universal citizenship as a fundamental pedagogical target. Starting from some specific philosophical and theoretical studies (Fowler, 2000, 2017; Moscato, Gatti, Caputo, 2012), we carried out several exploratory surveys (Caputo, 2012; Caputo, Pinelli, 2014), and we also acquired some empirical data during some interreligious formative seminars (Draghetti, Pinelli, 2019). We also carried out a national research by survey in Italy, involving a significative sample of 2.675 religious people, which provided many data about the representations and experiences connected to the religious dimension (Moscato, Caputo, Gabbiadini, Pinelli, Porcarelli, 2017). When we speak about the “religious dimension”, it is necessary to distinguish some elements in it. First of all, religiosity: an interactive and dynamic connection between an institutional, historical religion and the psychological and spiritual dynamisms linked to it. Religiosity has a subjective, concrete dimension, composed by psychological, anthropological and philosophical elements. Secondly, the religious sense, which we hypothesize to be the transculturally characterized generative element of the religious experience. Both of the above mentioned elements have to be differentiated from religion, which is an institutional symbolic system characterized by a proper theological and philosophical apparatus, a specific rituality and an organized structure. The interreligious dialogue does not happen among religions, but first of all among people’s religious experiences (Draghetti, Pinelli, 2019). The scientific and social disqualification of religion itself (Caputo, 2019) has delegitimized religiosity as well, reducing it to a mere emotive-affective dimension. On the contrary, as we will try to demonstrate, religiosity presents a positive potential also with respect to civil cohabitation, on condition that it is understood and promoted through conscious educative processes. The evolution of the religious conscience toward tolerance can be born only from a religiosity able to understand the human limits in receiving any possible “revelation”, and consequently able to presume that the one God may have been known by different names or perceived tentatively. Under these conditions, we will be able to reduce conflict among human interpretations, even in religious matters.

Background Elevation of right atrial pressure is a typical feature of acute heart failure (AHF), it is transmitted to renal veins leading to persistent kidney congestion. We aimed to evaluate the role of Doppler ultrasound in monitoring kidney congestion during diuretic therapy. Methods 71 patients (26 F - mean age 80.8±8.2 - mean EF 0.40±13.2) admitted for AHF underwent cardiac and renal Echo Doppler examination at day 1–3–5 of Hospital stay. Parameters of arterial and venous flow within cortical right kidney were recorded. Venous Doppler Profile (VDP) was classified as: continuous (C), pulsatile (P), biphasic (B) or monophasic (M) according to the growing degree of derangement. Arterial resistive index (RI) >0.8 was considered elevated. Correlation between renal hemodynamic changes and clinical outcome (Death and cardiovascular (CV) hospitalization) at 60 days was sought. Outcome VDP derangement (M or B) was detected in 57 patients (80.3%) at day 1 and in 36 at day 5 (52.2%, p After 60 days, 13 (18.3%) patients died and 8 (11.3%) had a CV hospitalization. Kaplan Meier analysis found a significant better outcome in those patients whose VDP did improve after diuretic therapy (Log Rank test p Conclusions Most patients admitted with AHF present deranged VDP. Diuretic treatment lead to VDP improvement and to renal RI decrease. In this perspective study, for the first time VDP improvement after endovenous diuretic treatment resulted associated to reduced risk of death and CV Hospitalization. Evaluation of VDP could become a useful tool in monitoring the efficacy of diuretic treatment in AHF. Funding Acknowledgement Type of funding sources: None. Table 1. Patients characteristics and VDPFigure 1. Kaplan-Meier estimate curve

BACKGROUND Acute heart failure (AHF) seems to provoke profound derangement of abdominal hemodynamic, which causes symptoms and impacts on renal function. METHODS 27 patients (10 F - age 78 - EF 0.39) admitted for AHF underwent cardiac and abdominal ultrasound at day 1 and 5. Arterial and venous flow within liver, spleen and kidney were recorded. Portal and Splenic Vein flow was described as continuous, pulsatile or reversed, whereas hepatic vein systolic and diastolic ratio was measured. Renal Venous Doppler Profile (VDP) was classified as: continuous, pulsatile, biphasic or monophasic. Arterial Resistive Index (RI) ≥0.7 was considered elevated. OUTCOME At day 1 most patients presented with some degree of deranged VDP and high RI in all examined organs. At day 5, a significant proportion of patients improved their VDP in Liver, Kidney and Spleen, while the percentage of patients with collapsing IVC did not significantly change. On the arterial side, the proportion of patients with high Hepatic RI dropped significantly. CONCLUSIONS Our preliminary data show that most deranged VDP in abdominal organs and Hepatic RI improve after decongestion despite a nonsignificant trend in improvement in IVC profile. RESULTS Classification day 1 day 5 p IVC Collapsing 24% 34% ns Portal Vein Continous 22% 50% Pulsatile 72% 50% Reversed 6% 0%

Background Acute heart failure (AHF) is often accompanied by impairment in renal function. A profound derangement of normal abdominal haemodynamic is always present during this clinical phase. Methods 14 patients (6 F – mean age 80 – mean EF 0.39) admitted for acute heart failure underwent cardiac and renal Echo Doppler examination at day 1-3-5 of Hospital stay. Parameters of arterial and venous flow within cortical right kidney were recorded. Venous Doppler Profile (VDP) was classified as: continuous (C), pulsatile (P), biphasic (B) or monophasic (M) according to the growing degree of derangement. Arterial resistive index (RI) >0.8 was considered elevated. Correlation between renal hemodynamic (and its changes) with biohumoral and echo parameters was sought. Outcome At day 1 VDP was M or B in 8 patients (57%) and in four (50%) of them dropped to C or P at day 5. RI was elevated in 8 patients at day 1 while only in 4 at day 5. VDP and RI were not related to EF or BNP values. One patient died before day 5, no other worsening heart failure episodes occurred. Two patients (14%) developed acute kidney injury but their VDP and RI were normal and did not change. Three patients (21%) did not improve their BNP (decrease >30%) but this was not associated with VDP or RI changes. Elevated derived pulmonary artery systolic pressure (>40 mmHg) was present in 6 out of 8 patients (75%) with M or B VDP and in all 4 patients with both elevated RI and M or B VDP. Venous Pattern Day 1 Day 3 Day 5 Continous 2 8 5 Pulsatile 4 2 4 Biphasic 2 1 2 Monophasic 6 3 2 Arterial RI >0.8 8 6 4 BNP, pg/ml 1060±1180* 372±281* 424±213* Creatinine, mg/dl 1.4±0.6 1.5±0.6 1.3±0.6 Hb, g/dl 12.1±2.3 12.3±3.6 13.2±2.3 *p>0.05. Conclusions This is the first study exploring changes in renal hemodynamic by echo Doppler during AHF. With respect to previous studies among stable patients, our preliminary data shows a higher proportion of deranged renal venous and/or arterial pattern. After diuretic therapy a trend towards improvement in VDP was recorded. No clear association with other clinical and hemodynamic parameters seems evident.

This paper deals with the automatic classification of Drones using a surveillance radar signal. We show that, using state-of-the-art feature-based machine learning techniques, UAV tracks can be automatically distinguished from other object (e.g. bird, airplane, car) tracks. In fact, on a collection of real data, we measure an accuracy higher than 98%. We have also exploited the possibility of using the same features to distinguish the type of the wing of drone, between Fixed Wing and Rotary Wing, reaching an accuracy higher than 93%.

Hintergrund: Evaluierung der klinischen Ergebnisse 3 Monate nach Implantation einer neuen diffraktiven multifokalen Intraokularlinse (MIOL) mit einer reduzierten Nahaddition von + 2,75 dpt. Methoden: Im Rahmen einer prospektiven Studie wurden Patienten nach erfolgreicher Kataraktoperation oder refraktivem Linsenaustausch mit Implantation einer MIOL (Tecnis ZKB00, Abbott Medical Optics, Santa Ana, California, USA) eingeschlossen. Drei Monate postoperativ wurde die Sehscharfe in unterschiedlichen Testentfernungen bewertet. Bei den postoperativen Untersuchungen nach einer bilateralen IOL-Implantation wurde zusatzlich ein Fragebogen zur Evaluierung der subjektiven Zufriedenheit, der Sehqualitat und der Tragegewohnheiten einer Brille vorgelegt und in die Auswertung mit einbezogen. Ergebnisse: Es wurde zwischen Oktober 2013 und August 2014 bei 115 Augen von 62 Patienten die ZKB00-IOL implantiert. Die postoperative Refraktion lag im spharischen Aquivalent bei − 0,27 ± 0,44 dpt. Der korrigierte binokulare Fernvisus lag bei − 0,01 ± 0,3 logMAR. Der unkorrigierte binokulare Fernvisus wurde mit 0,06 ± 0,08 logMAR nach 3 Monaten ermittelt. Im Nahbereich konnte die unkorrigierte binokulare Sehscharfe mit 0,07 ± 0,10 logMAR nach 3 Monaten postoperativ bestimmt werden. Schlussfolgerung: Die ZKB00-IOL gehort einer neuen Generation von MIOL an, die einen deutlich verbesserten Intermediarvisus anbieten. Unsere Studie belegte fur die Implantation dieser IOL eine ausgezeichnete Sehfunktion in allen Bereichen in Korrelation mit einer sehr hohen allgemeinen Patientenzufriedenheit und einer subjektiv hohen Abbildungsqualitat.

Coastline detection in synthetic aperture radar (SAR) images is crucial in many application fields, from coastal erosion monitoring to navigation, from damage assessment to security planning for port facilities. The backscattering difference between land and sea is not always documented in SAR imagery, due to the severe speckle noise, especially in 1-look data with high spatial resolution, high sea state, or complex coastal environments. This paper presents an unsupervised, computationally efficient solution to extract the coastline acquired by only one single-polarization 1-look SAR image. Extensive tests on Spotlight COSMO-SkyMed images of complex coastal environments and objective assessment demonstrate the validity of the proposed procedure which is compared to state-of-the-art methods through visual results and with an objective evaluation of the distance between the detected and the true coastline provided by regional authorities.

In the context of automatic image processing, the noise nearly always represents the hardest problem to cope with. This is particularly true on images corrupted by multiplicative speckle noise, such as Synthetic Aperture Radar (SAR) images. To tackle such an issue, this paper proposes a novel anisotropic diffusion filter that manages to fulfill simultaneously two competing requirements: noise reduction on homogeneous regions and edge enhancement. To prove the capabilities of our filter, we compare it to two non-local diffusion (NLD) filters applied on Lena image corrupted by a multiplicative speckle noise and on a real SAR image acquired by the COSMO-SkyMed (CSK) satellite constellation.

Evaluation of the clinical data 3 months after implantation of a new diffractive multifocal intraocular lens (MIOL) with a reduced near add power of + 2.75 D.In a prospective study, patients who underwent cataract surgery or refractive lens exchange with implantation of an MIOL (Tecnis ZKB00, Abbott Medical Optics, Santa Ana, California, USA) were included. Three months postoperative corrected and uncorrected visual acuities at different distances were measured and evaluated. Those patients that underwent bilateral MIOL implantation additionally filled out a questionnaire 3 months postoperatively.Between October 2013 and August 2014, 115 eyes of 62 patients were implanted with the ZKB00 IOL. Mean postoperative refractions were - 0.27 ± 0.44 D for the spherical equivalent, respectively. Mean binocular CDVA was - 0.01 ± 0.3 logMAR with a mean binocular UDVA of 0.06 ± 0.08 logMAR. For near distance in 40 cm, an UNVA of 0.07 ± 0.10 logMAR three months postoperatively was measured.The ZKB00 IOL belongs to a group of novel MIOL with an increased intermediate visual performance. Our study shows good visual acuity at all distances, as well as a high rate of satisfaction and subjectively good image quality.

This study explores the potential of Synthetic Aperture Radar (SAR) to aid Unmanned Aerial Vehicle (UAV) navigation when Inertial Navigation System (INS) measurements are not accurate enough to eliminate drifts from a planned trajectory. This problem can affect medium-altitude long-endurance (MALE) UAV class, which permits heavy and wide payloads (as required by SAR) and flights for thousands of kilometres accumulating large drifts. The basic idea is to infer position and attitude of an aerial platform by inspecting both amplitude and phase of SAR images acquired onboard. For the amplitude-based approach, the system navigation corrections are obtained by matching the actual coordinates of ground landmarks with those automatically extracted from the SAR image. When the use of SAR amplitude is unfeasible, the phase content can be exploited through SAR interferometry by using a reference Digital Terrain Model (DTM). A feasibility analysis was carried out to derive system requirements by exploring both radiometric and geometric parameters of the acquisition setting. We showed that MALE UAV, specific commercial navigation sensors and SAR systems, typical landmark position accuracy and classes, and available DTMs lead to estimated UAV coordinates with errors bounded within ±12 m, thus making feasible the proposed SAR-based backup system.

Correct identification of obstacles at the periphery of airports is an important issue to ensure safe takeoff, flight, and landing to aircrafts. This work is carried on as part of the obstacle risk assessment and risk mitigation operations in the aviation security framework. This paper presents a novel fully automatic remote sensing methodology for the detection, shape and signature extraction and classification of obstacles to air navigation from very high resolution (VHR) multispectral (MS) satellite stereo couples images, here defined feature extraction (FE). In order to reduce the costs, the proposed technique is applied only on detailed areas where orographic/topographic changes potentially associated with variations in the obstacles to air navigation in wide areas have been previously detected through a low-cost pre-screening change detection (CD) methodology applied to cheaper high resolution (HR) satellite imagery. The combination of CD and FE strategies offers a low-cost and fast solution to the problem of updating airport obstacle chart.

In this paper a high-frequency large-bandwidth synthetic aperture penetrating radar intended for the inspection of masonry walls, and its application to intrawall investigation of an important Heritage structure in Florence, Italy, are described. The radar system has been conceived and designed for non-contact operation, in particular for allowing walls covered by paintings to be inspected avoiding damages to the surface artworks. The radar signal was a Continuous-Wave Step-Frequency (CW-SF) waveform, sampling a 4 GHz bandwidth at 10 GHz center frequency, thus providing relatively high resolution images of the investigated structures. Cross-range resolution is provided by applying a synthetic aperture approach, obtained by mechanically moving the radar antenna along a 2 m length aperture. In order to assess the radar performances and its detection capability, laboratory tests on masonry facilities were preliminarily performed. Finally, an extensive measurement campaign was carried out on a famous 16th century structure: the ‘Hall of 500’, in Palazzo Vecchio (Old Palace), in Florence (Italy). This investigation was aimed at finding evidence of possible discontinuities in the masonry walls, where fragments of the famous fresco the ‘Battle of Anghiari’ by Leonardo da Vinci could be hidden.

In synthetic aperture radar (SAR) images, the speckle noise often corrupts salient information that is of interest (e.g. textures, small hard targets, object boundaries, etc.). To tackle such an issue, proposed is a novel anisotropic diffusion filter that manages to simultaneously fulfil competing requirements: noise reduction on homogeneous regions, weak edges preservation, and keeping hard targets intact. The capabilities of the proposed filter were proved by comparing it with another two non-linear diffusion filters applied on a Lena image corrupted by a multiplicative speckle noise and on a real SAR image acquired by the Cosmo-SkyMed satellite constellation.

We report a case of aortocaval fistula demonstrated with gadolinium-enhanced magnetic resonance (MR) angiography. Specific radiographic features of this rare complication, such as early and intense enhancement of the inferior vena cava, are underlined with MR imaging. The exact location of the fistula can also be assessed with this noninvasive imaging technique. Moreover, the absence of iodinated contrast media makes it particularly suited for stable patients with renal insufficiency. A complete preoperative assessment of abdominal aortic aneurysm can be performed with MR imaging.

A three-antenna synthetic aperture radar interferometer (InSAR) with a statistically optimal data processor for three-dimensional (3D) terrain mapping has been proposed recently to reduce the phase ambiguity and data-noise drawbacks of the conventional two-antenna SAR interferometry technique. In this paper, a numerical simulator is developed to assess the achievable performance and various design tradeoffs of the three-antenna InSAR. The most critical conditions for the new reduced-ambiguity system operating on realistic scenes are taken into account. The phase-unwrapping procedure is included in the simulator to compare the new and the conventional technique in terms of both phase and height-estimation accuracy. The performance achievable by a three-antenna airborne InSAR system on a given site are analyzed, and the parameter optimization of the new system is investigated. The results of several case studies show that the new technique can outperform the conventional one significantly for a typical airborne configuration, especially for high-terrain steepness. It provides reduced-phase aliasing and better estimation accuracy. So, the phase unwrapping Is simplified and high-quality maps of terrain height can be obtained. As a limit, absolute phase retrieval can be achieved with good accuracy and the unwrapping procedure can be avoided.

The authors propose the use of a high-speed interferometric radar for remotely measuring both transient displacements and steady-state vibrations of architectural heritage structures in order to test their stability conditions. Demonstrative results of application of the technique to a prominent cultural heritage artwork, the tower of Giotto in Florence, Italy, are reported.

In the context of high spatial resolution Synthetic Aperture Radar (SAR) images, this paper deals with a new computationally efficient algorithm which allows us to accurately detect ships of certain dimensions, which can span in a range supposed known. The topic of ship detection in SAR imagery has been extensively analyzed in literature. However, little is known about such application on SAR data acquired by COSMO-SkyMed (CSK) satellite constellation. Commonly, in SAR images, ship detection methods rely on sea (background) statistical characterization. Nevertheless, such approaches typically require a high computational load. Thus, the time required by classic detection algorithms (e.g. Constant False Alarm Rate - CFAR) may become critical in the context of ship detection for maritime surveillance. In this paper we present a new computationally efficient algorithm for ship detection in SAR images, which is not a CFAR approach. Our algorithm is obtained modifying the classical two-classes segmentation provided by Otsu's histogram thresholding algorithm. Such modifications are necessary to apply Otsu's algorithm in SAR images. They are based on the geometrical proprieties of the target to be detected, i.e. ships whose dimensions can span in a range a priori known. Proofs of the goodness of our algorithm are given on a CSK image acquired over New York.

This paper presents selected results obtain under SARINA project. SARINA is a SAR-based Augmented Integrity Navigation Architecture proposed by authors of this paper. The main goal of the SARINA project was designing and assessing a novel aircraft Inertial Navigation System (INS) for missile and UAV that will make use of features extracted from SAR/InSAR imagery and on-board terrain landmark database in order to ensure robustness against uncompensated IMU errors due to possible GPS lack of.

This paper presents an automatic pre-screening algorithm of SAR images of huge size (more than 20;000×20;000 pixels), which is capable to identifying extended infrastructures in an effective and computationally efficient way. The algorithm is tested on true one-look Cosmo-SkyMed SAR image data for target detection purposes on an airport scenario. Both visual and objective results are presented to show the potentials of the proposed method.

We examined 166 patients with advanced chronic obstructive pulmonary disease (COPD) treated with long-term oxygen therapy (LTOT) in order to evaluate the prognostic factors of such patients. The mean observation period was 24 months (range 2-50 months) and the following variables were considered: age, forced expiratory volume in 1 s (FEV1), arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2), hematocrit, right ventricular systolic pressure (RVSP; evaluated by Doppler echocardiography), number of hospitalizations in the 2 years prior to prescription of LTOT and body mass index. The overall survival rate was 78.3% at 24 months and 67.1% at 36 months. A univariate analysis identified three variables as significant predictors of survival: FEV1, PaO2 and RVSP. A multivariate analysis, using Cox's model, showed an independent predictive power for RVSP, age and FEV1. RVSP higher than 35 mm Hg, age greater than 70 years and FEV1 lower than 30% of the predicted value were associated with shortened survival. The importance of pulmonary hypertension as a predictor of death suggests that LTOT could be prescribed earlier for COPD patients with cor pulmonale, as oxygen has been shown to be the only effective therapy for improving the survival probability of these patients.

In the context of augmented integrity Inertial Navigation System (INS), recent technological developments have been focusing on landmark extraction from high-resolution synthetic aperture radar (SAR) images in order to retrieve aircraft position and attitude. The article puts forward a processing chain that can automatically detect linear landmarks on highresolution synthetic aperture radar (SAR) images and can be successfully exploited also in the context of augmented integrity INS. The processing chain uses constant false alarm rate (CFAR) edge detectors as the first step of the whole processing procedure. Our studies confirm that the ratio of averages (RoA) edge detector detects object boundaries more effectively than Student T-test and Wilcoxon-Mann-Whitney (WMW) test. Nevertheless, all these statistical edge detectors are sensitive to violation of the assumptions which underlie their theory. In addition to presenting a solution to the previous problem, we put forward a new post-processing algorithm useful to remove the main false alarms, to select the most probable edge position, to reconstruct broken edges and finally to vectorize them. SAR images from the “MSTAR clutter” dataset were used to prove the effectiveness of the proposed algorithms.

This paper presents the concept of Synthetic Aperture Radar (SAR) and Interferemetric SAR (InSAR) georeferencing algorithms dedicated for SAR based augmented Inertial Navigation Architecture (SARINA). The SARINA is a novel concept of the Inertial Navigation System (INS), which utilized the SAR radar as an additional sensor to provide information about the platform trajectory position and compensate an aircraft drift due to Inertial Measurement Unit (IMU) errors, Global Positioning System (GPS) lack of integrity, etc.

The purpose of this study was to investigate the feasibility of cardiac microdialysis for the in vivo estimation of cardiac interstitial peptide concentrations, and, to determine the changes in neuropeptide Y release in myocardial tissue during experimental brain death in pigs. Using a specifically designed concentric flexible probe, perfused with Ringer solution containing 0.5% of bovine serum albumin at a flow rate of 2 μl/min, allowed us to obtain a 23 ± 2% relative recovery rate in vitro. Based on these in vitro recovery data, a regional study of the kinetics of interstitial NPY levels following brain death was obtained by monitoring the changes in NPY dialysate levels recorded from dialysis probes implanted into the right and left ventricular walls of the beating heart in vivo. Basal dialysate NPY levels determined by radioimmunoassay were of 95.2 ± 7.0 and 93.2 ± 9.1 pmol/l in left and right ventricle, respectively. Brain death was followed by a sustained 2 h increase in NPY dialysate levels in both ventricles (peak levels: 173.2 ± 30.9 pmol/l in left ventricle, and 149.7 ± 23.9 pmol/l in right ventricle), which then returned to control levels. We conclude that cardiac microdialysis is a simple and promising new tool for evaluating the role of peptides in cardiovascular regulation.

Ofloxacin penetration into heart tissue (valve and myocardium), mediastinal fat, and sternal bone marrow was the object of a prospective nonrandomized study. Thirty-six patients undergoing mitral and/or aortic valve replacement were included. Patients were divided into two groups of 18 patients each. Group 1 patients were administered a single 400-mg intravenous dose of ofloxacin over a 30-min period upon anesthesia (n = 6) or at 1 h (n = 6) or 6 h (n = 6) prior to surgery. Group 2 patients received a 200-mg oral dose of ofloxacin every 12 h during the 48 h preceding surgery. In this group, the final dose of ofloxacin was administered 3 h (n = 9) or 8 h (n = 9) before anesthesia. Plasma and tissue ofloxacin concentrations were assayed by high-pressure liquid chromatography. In group 1 patients, the peak level in plasma was 15.9 +/- 2.5 micrograms/ml. Peak ofloxacin levels in tissue were reached by hour 1 and were 8.89 +/- 2.16 micrograms/g in myocardium and 5 +/- 0.75 micrograms/g in heart valves. A significant decrease in ofloxacin levels in heart valve tissue and sternal bone marrow was observed after hour 3. Nevertheless, ofloxacin myocardial, heart valve, and sternal bone marrow levels remained higher than the MICs for the usually susceptible pathogens for at least 3 h. In group 2 patients, myocardial levels were long lasting (6.46 +/- 1.92 micrograms/g [4 to 8 h] and 5.92 +/- 0.95 micrograms/g [8 to 12 h]) and remained higher than those observed in the other tissues over the entire study period. A progressive but insignificant decrease in ofloxacin heart valve levels was observed (from 2.46 +/- 0.40 micrograms/g [4 to 8 h] to 1.57 +/- 0.22 micrograms/g [8 to 12 h]). In both groups, concentration in mediastinal fat were lower and tended to decrease with time. These were 1.83 +/- 0.61 micrograms/g with the first hour and 0.85 +/- 0.43 micrograms/g between hours 8 and 12 in group 1 and 1.74 +/- 0.52 micrograms/g between hours 4 and 8 and 0.67 +/- 0.11 micrograms/g between hours 8 and 12 in group 2. In conclusion, satisfactory diffusion of ofloxacin into heart tissue seems to favor use of the drug in the treatment of bacterial endocarditis due to susceptible pathogens. Furthermore, the progressively decreasing concentrations observed in heart valve and sternal bone marrow and the poor levels achieved in mediastinal fat suggest the need for renewing injection 3 h following initial infusion if the drug is used as an antibiotic prophylactic agent during cardiovascular surgery.

The purpose of this study was to compare the early postoperative effects of heart and heart-lung transplantation on the secretion of atrial natriuretic peptide (alpha-ANP), renin, aldosterone, and vasopressin. This was carried out from the first to the eighth postoperative day in ten heart and five heart-lung recipients. The changes in the release of these hormones were similar in both groups. Vasopressin release remained stable while that of the renin-angiotensin-aldosterone system progressively returned to more normal levels. Grafted heart tissue was capable of high alpha-ANP release early on in both heart and in heart-lung recipients. This sustained alpha-ANP release was not a function of the resulting overall atrial tissue mass. Our findings suggest that it might be the consequence of an intrinsic hypersecretion of alpha-ANP resulting from the loss of normal heart innervation occurring in both heart and heart-lung transplantation.

The first studies about fertility and nutrition date back to the 70ies and already showed a strict relation among female fertility, weight and body composition. However, the mechanisms of this connection started to be explained only after leptin's discovery. According to some authors' opinion, leptin could interact with reproductive axis at multiple sites with stimulatory effects at the hypothalamus and pituitary and stimulatory or inhibitory actions at the gonads. Leptin could play a role in other physiologic processes such as menstruation and pregnancy, and could initiate the complex process of puberty. It has been showed that conditions in which nutritional status is suboptimal, such as eating disorders, exercise induced amenhorrea, functional hypothalamic amenhorrea and polycystic ovarian syndrome, are associated with abnormal leptin levels. These conditions, are characterized by severe changes in body composition and dietary habits. Since leptin is regulated by body composition and dietary factors, (such as energy intake and macronutrient composition), a strict connection between nutritional intake and fertility regulated by leptin is confirmed. This review focuses on the current knowledge about nutritional factors that influence leptin levels. Since clinical and subclinical nutritional imbalance can determine the development and the maintenance of neuroendocrine and metabolic aberrations, studies on fertility need a deeper attention about dietary habits and nutritional status.

In chronic pulmonary vascular thrombotic disease, pulmonary thromboendarterectomy lure proved to be effective in reducing pulmonary hypertension and improving gas exchange. However, persistent pulmonary hypertension and unrelenting reperfusion edema are the main causes of death. We report a case of pulmonary thromboendarterectomy followed by an immediate unfavorable postoperative course with acute and persistent pulmonary hypertension, gas exchange impairment, and heart dysfunction. In this particular case, inhaled nitric oxide was successfully administered.

The occurrence of neurologic complications after cardiac surgery varies widely and has increased during the last years for several reasons: older age of patients, higher prevalence aortic valve replacement, and more careful diagnosis of cerebral ischemia. Recent studies showed that embolic mechanism is involved in most patients, and two main clinical outcomes are detectable: type I outcome, consisting of TIA and ischemic stroke, and type II outcome, consisting of cognitive defects and seizures. The overall prevalence of neurologic complications after cardiac surgery is nearly 16% and suggests the need of systematic preoperative evaluation of patients for identifying those with high risk and the individualization of the surgical strategy. The preoperative work-up should include two-dimensional echocardiography, transesophageal echocardiography (for detecting patients with ascending aortic lesion who need alternative surgical strategies, i.e. different site of cross clamping, cannulation, and proximal anastomosis of the venous graft), Doppler ultrasound of carotid arteries (for identifying those candidates to combined surgery), and psychobehavioural evaluation (for selecting patients with cognitive deterioration who could be treat by off-pump surgery). In conclusion, a preoperative stratification of the neurologic risk, and a more careful postoperative monitoring should be mandatory for preventing and adequately treating neurologic complications of cardiac surgery.

The features of a computerized system for the management of an outpatient cardiology clinic are described. The local area network (LAN) is based on the ETHERNET standard, with a minicomputer Unisys 5000/95 as the central unit and several PCs and videoterminals as workstations. The operating systems are UNIX System V.3 and MS-DOS. The relational database management system (RDBMS) is ORACLE, and for data analysis and retrieval the SQL-Plus language is used. The PCs can act as independent workstations, using the MS-DOS operating system and standard software packages for office automation. The program manages appointments, patient records, and laboratory test reports. >

The prognostic value of echocardiographic findings in patients with heart failure is well known. In contrast, few studies have addressed the changing significance of echocardiographic findings during the natural history of heart failure. Ejection fraction is useful for stratifying the cardiac risk in the early phase of the disease, but a further risk stratification among patients with ejection fraction30%,25%, or20% has not been observed. On the other hand, the identification of a "restrictive" left ventricular filling pattern allows to select patients with poor prognosis among those with advanced heart failure. In patients with mild to moderate heart failure, the prognostic risk should be assessed by ejection fraction and left ventricular filling pattern integrated with other echocardiographic findings such as pulmonary venous flow pattern, right ventricular function, and transmitral flow pattern changes after exercise. In conclusion, the prognostic significance of echocardiographic findings varies during the natural history of heart failure, and therefore may differ in the way it influences the management and therapeutic approach.

A case of post-transplant lymphoproliferative disease (PTLD) with donor heart involvement is reported. The 49-year-old patient presented with heart failure initially ascribed to acute graft rejection. The treatment with high doses of immunosuppressive agents was unsuccessful and the outcome rapidly fatal. This case suggests that cardiac failure occurring after high doses of immunosuppressive therapy could be a sign of early PTLD in heart transplant recipients.

Exercise training is a recommended treatment for chronic heart failure. So far, randomized clinical trials showed that exercise training can improve peak oxygen consumption and reduce neurohormonal and adrenergic activation, nevertheless, the effect on left ventricular remodeling is still controversial. The present study reviewed the randomized clinical trials that investigated the effects of exercise training on left ventricular remodeling. After a first study that showed a worsening of left ventricular function, the following studies showed a neutral effect, and finally, the ELVD-CHF study showed both a reduction in left ventricular dilation and an improvement of ejection fraction. These different results could be explained by the pharmacological treatment before exercise training: in the first study patients did not assume ACE-inhibitors, in the following studies most patients assumed ACE-inhibitors and, finally, in ELVD-CHF, patients assumed ACE-inhibitors and about one fifth of them were on beta-blockers too. In conclusion, exercise training may improve peak oxygen consumption and reduce neurohormonal and adrenergic activation in patients with chronic heart failure. Further studies are necessary to assess if exercise training, associated with ACE-inhibitors and beta-blockers, can reverse or prevent left ventricular remodeling.

The authors report the case of a young woman (47 yrs old) who underwent cardiac evaluation for recurrent unexplained cerebral transient ischemic attacks. In the search for a source of embolization, a transesophageal echocardiography was performed and this revealed an atherosclerotic complex plaque of the ascending aorta as the sole potential source of cerebral embolism, while the remaining aortic wall was normal. The atheroma showed a calcific portion inserted on the aortic wall and a mobile hypoechogenic portion protruding into the aortic lumen. Furthermore, we found increased levels of cholesterol, fibrinogen and plasmatic homocysteine after methionine loading. Atherosclerotic lesions of the aortic arch are a rare cause of embolism in young patients with stroke, but they can lead to important complications such as thrombosis and embolism, similar to atherosclerotic lesions in elderly patients. The mechanisms that predispose for atherosclerosis of the aorta in young patients are still unknown. It was recently reported that not only hypercholesterolemia but also elevated levels of fibrinogen and homocysteine are independent risk factors for cerebrovascular disease. It is possible that these factors may be important predictors of atherosclerosis of the thoracic aorta in young patients, but more clinical data are still necessary. This case report confirms the importance of performing a TEE study and examining the cholesterol, fibrinogen and homocysteine plasmatic concentrations in all of young patients with unexplained stroke or transient ischemic attacks.

Cardiac complications are frequent in patients with subarachnoid hemorrhage (SAH). They include ECG abnormalities, cardiac arrhythmias, myocardial damage, and neurogenic pulmonary edema. The pathophysiology of these abnormalities is related to an imbalance of the autonomic cardiovascular control and to increased circulating and local myocardial tissue catecholamines. Cardiac involvement is more common in patients with severe neurological deficits and it may increase the morbidity associated with SAH because of the occurrence of life-threatening arrhythmias or pulmonary edema. Monitoring of cardiac events in patients with SAH might result in a better understanding of their clinical outcome, as well as providing a basis for specific treatment capable of preventing myocardial necrosis and cardiac arrhythmias.

To report our personal experience with the locoregional treatment of breast cancer.Eighteen patients aged 33-67 years (mean: 54 years) were treated with 31 sessions of intra-arterial antiblastic infusion, 5 of them for neoadjuvant purposes (Group 1), 5 for palliation in unresectable tumors (Group 2) and 8 for cutaneous recurrences after mastectomy (Group 3).2/5 CR and 3/5 PR were obtained in Group 1; 2/5 lesions were made resectable and 3/5 RP obtained in stage III or unresectable lesions (Group 2). Finally, 3/8 CR, 3/8 PR, 1/8 SD and 1/8 PD were observed in Group 3. An objective response according to WHO criteria was demonstrated in 15/18 cases (88%). We had no post-treatment hematologic complications, but one patient presented focal subcutaneous sclerosis and one cutaneous necrosis.The morphological efficacy of intraarterial antiblastic infusion in our series was similar to that of other series. No definitive conclusions can be drawn yet about clinical results and long-term survival. This poorly invasive and low risk procedure, which should be combined with other treatments, permits to reduce the extent of surgery and to treat skin recurrences.

Three children with familial hypophosphatemic rickets showed, in the untreated state, active rickets of the metaphyseal areas of long bones. All were treated with combined phosphate /1-2 g daily by mouth in 4-5 divided doses) and vitamin D2 therapy for 2-5 years. The radiological appearance of the metaphyses became practically normal in two, whereas little change took place in the endosteal bone surface. Bone biopsies demonstrated osteomalacia. Therefore, two subjects were given phospate (1-2 g daily) and 1-alpha-hydroxyvitamin D (0.25-0.50 microgram daily) for 2 years; then phosphate (1 g daily) and 1.25 dihydroxyvitamin D (0.25-0.50 microgram daily) combined therapy for 5 years; the third patient had phosphate (1 g daily) and 1.25 dihydroxyvitamin D (0.25 microgram daily) combined therapy for 2 years. After therapy with low doses of 1.25 dihydroxyvitamin D, X-rays showed a nearly normal bone aspect, without nephrocalcinosis in all patients. All subjects were submitted to osteothomies with positive results.

Focal myocardial necrosis reported in patients who died of brain lesions and in donor hearts soon after insertion has been attributed to catecholamine-related injury induced before operation, or in the perioperative period. Interpretation of the morphofunctional type of myocardial injury observed and its quantification may help understand both its pathophysiology and clinical relevance.In 27 patients without heart disease who died of intracranial brain hemorrhage after berry aneurysm rupture, terminal clinical signs were correlated with the presence of absence of myocardial injury. All hearts were systematically examined, and the total histologic area was measured in square millimeters, with both the number of foci and myocardial cells showing necrosis, normalized to 100 mm2. Forty-five cases of fatal head trauma (26 "instantaneous" and 19 "rapid" deaths) in normal subjects and 38 cases of acquired immunodeficiency syndrome with (14 cases) or without (24 cases) severe brain damage were used as control subjects.Contraction band necrosis was the only form of myocardial necrosis found in 89% of patients with acute brain hemorrhage. Its extent was 26 +/- 34 foci and 67 +/- 104 necrotic myocardial cells x 100 mm2. In patients with acquired immunodeficiency syndrome, its frequency was 58% in those without and 78.5% with severe brain lesions, with foci and myocardial cell values of 1 +/- 1.5 and 10 +/- 22 and 7 +/- 16 and 17 +/- 32, respectively. In head trauma cases with instantaneous death, the frequency was 4% (one case only with foci 0.5 and myocardial cells 35), whereas with a rapid death it was 40% (foci 12 +/- 18 and myocardial cells 21 +/- 33).The observed myocardial injury was present in all groups examined, being maximal in patients with intracranial brain hemorrhage with longer survival and minimal in patients with head trauma who died instantaneously. In this setting, this lesion is typical of catecholamine myotoxicity and may express a sympathetic overstimulation either in the agonal period and independent of therapy or be caused by brain injury, especially intracranial brain hemorrhage. However, the extent of myocardial injury observed was minimal and should not jeopardize cardiac function if hearts from such subjects are transplanted.

In this paper we propose a two-dimensional fractal model of the sea surface defined by means of the solution of the sea hydrodynamic differential equations and based on the band-limited Weierstrass-Mandelbrot (WM) fractal functions. Fractal geometry is used to take into account of the multiscale nature of the sea and to give a better description of the fine structure of the sea surface. We determine a closed form expression of the directional sea wave spectrum, we derive the omnidirectional wave spectrum, the angular distribution function and we compare the results with the typical models proposed in the literature. The main contribution of the work is the definition of a new model of the directional sea wave spectrum. This is of interest to SAR imaging studies.